Background: Transposed brachio-basilic arteriovenous fistula (TBB-AVF) or arteriovenous graft (AVG) can be considered when primary and secondary vascular access options have been exhausted. Evidence that compared both procedures remains scarce. We aimed to report and describe the effectiveness of TBB-AVF and AVG as tertiary vascular access, reviewing literature about the advantages of each procedure.

Case Presentation: We presented a series of end-stage renal disease (ESRD) patients needing tertiary vascular access to compare each procedure's effectiveness. Our study included 17 patients with ESRD and multiple vascular access failures who needed tertiary vascular access for hemodialysis between January 2019 and August 2022. Patency in 6 months and 1 year were compared between TBB-AVF and AVG using the Kaplan-Meier curve. The early failure rate was 14.4% for TBB-AVF and 87.5% for AVG. TBB-AVF had a better patency rate than AVG (p=0.005; log-rank). Cumulative patency rates in six months and one year were 91.7% and 85.7% for TBB-AVF compared to 87.5% and 16.7% for AVG, respectively.

Conclusion: The creation of TBB-AVF should only be suggested if primary and secondary vascular access options have been exhausted. The TBB-AVF was more effective in functional patency than AVG as tertiary vascular access.

Background: Pancreatic cancer is the seventh leading cause of cancer death globally according to the 2020 Global Cancer Statistics. Pancreatic cancer does not show clear clinical signs in its early stages and it is usually diagnosed in the advanced phase with poor response to treatment. The risk is increased in smokers, black race, high-fat diet, alcohol, the elderly, the presence of infection, diabetes mellitus, and chronic pancreatitis.

Case report: We report a 72-year-old female patient with complaints of abdominal enlargement and jaundice. Patients also with complain of light colored stools and dark urine. Physical examination revealed tenderness on palpation of the right upper quadrant of the abdomen accompanied by an enlarged liver. Laboratory examination revealed anemia accompanied by an increase in total bilirubin with predominance in direct bilirubin. HbsAg examination showed positive results. Ultrasound examination showed a mass in the head of the pancreas with dilatation of the common bile duct to the intrahepatic bile duct and there was a hydrops gallbladder. Abdominal CT scan showed a well-defined contrast-enhanced mass measuring 36 cm x 4.4 cm x 6 cm in the head area.

Conclusion: Pancreatic head cancer is a rare type of cancer, but has a high malignancy. Establishing the correct diagnosis is generally difficult. This is because symptoms generally appear after the cancer has reached an advanced stage.

Latar Belakang: Kanker pankreas menjadi penyebab kematian ketujuh terbanyak akibat kanker secara global menurut Global Cancer Statistics tahun 2020. Kanker pankreas tidak menunjukkan tanda-tanda klinis yang jelas pada fase awal dan biasanya didiagnosis pada fase lanjut dengan respon yang buruk terhadap pengobatan. Risiko meningkat pada perokok, ras kulit hitam, diet tinggi lemak, alkohol, lansia, adanya infeksi, diabetes mellitus, dan pankreatitis kronis.

Laporan kasus: Kami melaporkan seorang pasien wanita berusia 72 tahun dengan keluhan keluhan pembesaran abdomen dan jaundice. Pasien juga dengan keluhan feses berwarna terang dan urin gelap. Ditemukan nyeri tekan pada palpasi kuadran kanan atas abdomen disertai pembesaran hati. Pemeriksaan laboratorium didapatkan anemia disertai peningkatan pada bilirubin toal dengan dominan pada bilirubin direk. Pemeriksaan HbsAg menunjukkan hasil positif. Pemeriksaan ultrasonograafi menunjukkan adanya massa pada caput pancreas dengan dilatasi common bile duct hinga intrahepatic bile duct dan terdapat hydrops gall bladder. Pemeriksaan CT scan abdomen menunjukkan massa menyangat kontras berbatas tegas ukuran  36 cm x 4,4 cm x 6 cm di daerah caput.

Kesimpulan: Kanker caput pancreas merupakan jenis kanker yang tergolong jarang, namun memiliki keganasan yang tinggi. Penegakan diagnosis yang tepat pada umumnya mengalami kesulitan. Hal ini disebabkan karena gejala pada umumnya muncul setelah kanker telah mencapai stadium lanjut.

Background: Condyloma lata is a form of secondary syphilis that manifest in moist, flat, firm boundaries papules or plaques with macerated surface that resembles the appearance of bowenoid papulosis. Differentiating this disease requires supporting examinations so that appropriate treatment can be determined. This case report discusses a case of condyloma lata, which was originally suspected to be bowenoid papulosis and accompanied by balanitis candida.

Case: A 14 years teenage boy, complained of warts near the anus and white spots on the gland penis since 1 month ago. Dermatovenereology examination on the perianal region showed a hyperpigmented solitary plaque, well-defined margin, geographic shape, flat surface and a solitary ulcer at the edges. On the glans penis, multiple white plaques, well defined, geographic shape, moist surface. Acetowhite examination was negative and a dark field microscope (DFM) examination of perianal lesions found Treponema pallidum. The potassium hydroxide examination on the glans penis found pseudohyphae and blastospores. Gram examination was found normal. The VDRL serology examination was reactive (1:64), and the TPHA was found to be reactive. The patient was diagnosed with condyloma lata coinfection with balanitis candida. Treatment involves a single intramuscular injection of benzathine penicillin 2.4 million IU and fluconazole 150 mg capsules intraorally single dose. Observations within 1 month showed clinical improvement in condyloma lata and balanitis.

Conclusion: This case provides an understanding of condyloma lata's clinical course, which mimics other diseases in an immunocompetent patient. Treatment based on etiology provides a good clinical improvement in patients.

Latar belakang: Kondiloma lata merupakan suatu bentuk sifilis sekunder yang dapat bermanifestasi berupa papul maupun plak yang lembab, datar, berbatas tegas dengan permukaan maserasi. Bowenoid papulosis adalah penyakit yang menyerupai gambaran kondiloma lata. Membedakan penyakit ini diperlukan pemeriksaan penunjang sehingga dapat menentukan pengobatan yang sesuai. Laporan kasus ini membahas kasus kondiloma lata yang semula diduga bowenoid papulosis dan disertai balanitis candida pada remaja laki-laki.

Kasus: Seorang remaja laki-laki, usia 14 tahun, mengeluhkan adanya kutil di dekat dubur dan bercak putih pada kelamin sejak 1 bulan yang lalu. Status dermatovenereologi pada regio perianal didapatkan plak soliter hiperpigmentasi, batas tegas, bentuk geografika, permukaan rata dan di tepinya terdapat ulkus soliter. Pada glans penis didapatkan plak putih multipel, berbatas tegas, bentuk geografika, permukaan lembab. Pemeriksaan acetowhite didapatkan negatif, pemeriksaan dark field microscope (DFM) pada lesi perianal didapatkan Treponema pallidum. Pemeriksaan kalium hidroksida (KOH) pada glans penis didapatkan adanya pseudohifa dan blastospora. Pemeriksaan gram pada glans penis tidak ditemukan adanya leukosit, kokus gram positif maupun batang gram negatif. Pemeriksaaan serologi Venereal Disease Research Laboratory (VDRL) reaktif 1:64  dan Treponema Pallidum Haemagglutination Assay (TPHA) didapatkan reaktif. Pasien didiagnosis kondiloma lata disertai balanitis candida. Penatalaksanaan dengan injeksi benzatin penisilin 2,4 juta IU intramuskular  dosis tunggal  dan flukonazol kapsul 150 mg intraoral dosis tunggal. Pengamatan dalam 1 bulan didapatkan perbaikan klinis pada kondiloma lata dan balanitis.

Simpulan: Kasus ini memberikan pemahaman mengenai klinis kondiloma lata yang menyerupai dengan penyakit lain dan disertai koinfeksi candida pada pasien imunokompeten. Penanganan berdasarkan etiologi memberikan perbaikan klinis yang baik pada pasien.

Introduction: Pulmonary hypertension (PH) is a pathological disorder of the pulmonary vessels that results in various clinical manifestations and causes cardiovascular and respiratory complications. This case report will discuss patients with heart failure due to rheumatic heart disease with severe mitral stenosis, moderate aortic stenosis, moderate-severe aortic regurgitation, severe tricuspid stenosis and the role of sildenafil in the preoperative period in patients with left heart valve disease with PH.

Case Description: A 40-year-old man came to the polyclinic complaining of fatigue and shortness of breath 6 months ago. From a regular S1 S2 heart examination, there was a murmur, and no signs of congestion were found in the patient. Electrocardiography showed 94 beats per minute sinus rhythm with poor R wave progression. On echocardiography found, patients with severe mitral stenosis, moderate aortic stenosis and regurgitation, and severe tricuspid regurgitation, with decreased LV systolic function and RV systolic function. The patient was planned for DVR + TV repair by a Cardiothoracic Surgeon. During the 24 hours preoperatively, the patient was given sildenafil 20 mg every 8 hours, which was continued for 72 hours postoperatively. The patient started mobilization on the third postoperative day, and there were no significant complications during the hospitalization. The patient was discharged on the 10th postoperative day with a total stay of 12 days.

Discussion: In patients with PH associated with left heart disease, the main strategy for repairing HP is to treat the underlying left heart condition. This also applies to significant left valve disease. One of the PH therapy options related to heart valve disease is sildenafil. Sildenafil relaxes pulmonary vascular smooth muscle and reduces pulmonary arterial pressure in various types of PH. Studies have shown that preoperative use of sildenafil significantly affects patients with PH associated with valvular heart disease. The administration of sildenafil is also effective for use postoperatively to reduce the need for postoperative inotropic support and reduce postoperative ventilation time.

Conclusion: One of the PH therapy options related to heart valve disease is sildenafil because of its effectiveness and relatively safe use before and after surgery.

Pendahuluan: Hipertensi Pulmonal (HP) merupakan kelainan patologis pada pembuluh darah paru yang mengakibatkan berbagai manifestasi klinis dan menimbulkan komplikasi kardiovaskular maupun respirasi. Pada laporan kasus akan dibahas pasien yang mengalami gagal jantung karena penyakit jantung rematik dengan stenosis mitral berat, stenosis aorta sedang, regurgitasi aorta sedang-berat, stenosis trikuspid berat serta peranan sildenafil pada masa pre-operatif pasien penyakit katup jantung kiri dengan HP.

Deskripsi Kasus:  Laki-laki usia 40 tahun, datang ke poliklinik jantung dengan keluhan cepat lelah dan mudah sesak sejak 6 bulan yang lalu. Dari pemeriksaan jantung S1 S2 reguler didapatkan adanya murmur dan tidak ditemukan tanda kongesti pada pasien Elektrokardiografi menunjukkan irama sinus 94 kali per menit dengan poor R wave progression. Pada ekokardiografi didapatkan pasien dengan stenosis mitral berat, stenosis dan regurgitasi aorta sedang, regurgitasi trikuspid berat, dengan fungsi sistolik LV dan fungsi sistolik RV yang menurun. Pasien direncanakan untuk tindakan double valve replacement dan tricuspid valve repair oleh sejawat Bedah Thoraks Kardiovaskular. Saat 24 jam pre operasi, pasien diberikan sildenafil 20 mg tiap 8 jam yang diteruskan hingga 72 jam pasca operasi. Pasien memulai mobilisasi pada hari ketiga pasca operasi dan tidak ada komplikasi signifikan yang dialami pasien selama rawat inap. Pasien dipulangkan pada hari ke 10 pasca operasi dengan total lama rawat 12 hari.

Diskusi: Salah satu opsi terapi HP terkait dengan penyakit katup jantung adalah sildenafil. Sildenafil merelaksasi otot polos pembuluh darah pulmonal dan menurunkan tekanan arteri paru pada berbagai jenis HP. Penelitian-penelitian menunjukkan penggunaan sildenafil sebelum operasi memiliki efek yang signifikan pada pada pasien dengan HP yang terkait dengan penyakit katup jantung. Pemberian sildenafil juga efektif digunakan pasca operasi sehingga dapat mengurangi kebutuhan akan dukungan inotropik pasca operasi dan mengurangi waktu ventilasi pasca operasi.

Simpulan: Sildenafil merupakan salah satu opsi terapi HP terkait dengan penyakit katup jantung dikarenakan efektivitasnya dan penggunaanya relatif aman untuk digunakan baik sebelum tindakan operasi maupun setelah tindakan operasi.

Introduction: Multiple myeloma is the second most common hematological malignancy after non-Hodgkin's lymphoma with a case prevalence in Prof. Dr. I.G.N.G. Ngoerah Hospital for the 2013-2017 period was 4.64% with the most cases occurring in 2017 (33.3%), where 45.8% of multiple myeloma patients were in the age group of 51-60 years old. This study aims to describe a case of multiple myeloma monoclonal gammopathy lambda in a young adult male which is a very rare case.

Case Presentation: 35-year-old male patient whose laboratory and radiological findings supported a diagnosis of multiple myeloma, the right clavicle pain was the primary complaint, and radiological imaging revealed brittle bones. Furthermore, the examination of bone marrow aspiration smear, serum protein electrophoresis, routine hematology, erythrocyte sedimentation rate, clinical chemistry (such as calcium, uric acid, liver function tests, urea and creatinine), and radiological examination, such as the plain X-ray of bone) shows prominent and specific laboratory findings to confirm multiple myeloma.

Conclusion: The diagnosis of multiple myeloma was established with manifestations of bone lesions, serum protein electrophoresis and bone marrow biopsy were carried out for diagnosis based on the International Myeloma Working Group (IMWG) diagnostic criteria. Monitoring after administering six series of primary management of multiple myeloma in patient showed significant improvement from the results of laboratory evaluation, radiology, and bone marrow imaging.

Latar Belakang: Multiple myeloma adalah keganasan hematologis kedua yang paling umum setelah limfoma non-Hodgkin dengan prevalensi kasus di RSUP Prof. Dr. I.G.N.G. Ngoerah periode 2013-2017 adalah 4,64% dengan kasus terbanyak terjadi pada tahun 2017 (33,3%), dimana 45,8% pasien multiple myeloma berada pada kelompok umur 51-60 tahun. Studi ini bertujuan ini untuk mendeskripsikan kasus multiple myeloma monoklonal gamopati lambda pada seorang laki-laki dewasa muda yang merupakan kasus sangat jarang.

Presentasi Kasus: Pasien laki-laki berusia 35 tahun dengan hasil laboratorium dan radiologis mendukung diagnosis multiple myeloma, nyeri klavikula kanan adalah keluhan utama, dan pemeriksaan radiologi menunjukkan tulang rapuh. Selanjutnya pemeriksaan apusan aspirasi sumsum tulang, elektroforesis protein serum, hematologi rutin, laju endap darah, kimia klinik (seperti kalsium, asam urat, tes fungsi hati, ureum, dan kreatinin), dan pemeriksaan radiologis, seperti foto polos X- ray tulang) menunjukkan temuan laboratorium yang menonjol dan spesifik untuk mengkonfirmasi multiple myeloma.

Simpulan: Diagnosis multiple myeloma ditegakkan dengan manifestasi lesi tulang, telah dilakukan pemeriksaan elektroforesis protein serum dan biopsi sumsum tulang untuk penegakan diagnosis berdasarkan kriteria diagnostik International Myeloma Working Group (IMWG). Monitoring setelah pemberian enam seri tatalaksana primer multiple myeloma pada pasien didapatkan perbaikan yang signifikan dari hasil evaluasi laboratorium, radiologis, dan gambaran sumsum tulang.

Background: Heteropagus or parasitic twin is a rare congenital anomaly that affects two connected children with imprecisely understood anatomy and physiology. This case report aims to describe a thoracopagus patient with severe complications.

Case presentation: One-day-old female baby was born with thoracopagus and omphalocele rupture. She was the third child, born aterm from a 36-year-old mother, with a birth weight of 3000 grams. Laboratory and radiography examinations showed leukocytosis, metabolic acidosis, prolonged coagulation profile, acute kidney injury, hypoglycemia, transaminitis, and congenital heart defects. She was treated in the intensive care unit and managed conservatively. Unfortunately, she died on the sixth day of treatment due to severe complications.

Conclusion: Conjoined twins have a poor prognosis. If it is coupled with other congenital anomalies, it will worsen the outcome.

Introduction: Supraventricular tachycardia (SVT) is one of the children's most common heart rhythm abnormalities. Episodes of SVT attacks in children are often recurring and, if not properly recognized, can be life-threatening. This case reports the incidence of SVT in children and its management, supported by a literature review

Case Description: A 1-year-old boy came to the hospital complaining of palpitations accompanied by an increase in carotid pulse and cold sweat 30 minutes before entering the hospital. The patient has a history of dilated cardiomyopathy and had the same complaint at the age of 6 months. On physical examination, blood pressure was 197/68 mmHg, pulse 235x/m, respiratory rate 32x/m accompanied by cold acral. The EKG showed SVT. Initial non-pharmacological management is carried out with vagal maneuvers, namely circular massage in the carotid sinus area for 10 seconds, followed by ice packs for 10 seconds. Then pharmacological cardioversion with amiodarone was carried out and continued with amiodarone maintenance therapy and treatment in the PICU room, as well as chest X-ray investigations and echocardiography.

Conclusion: Diagnosis of SVT is based on a detailed history and physical examination. EKG and echocardiography should be performed in children suspected of having SVT. Successful elimination of SVT results in improved quality of life in pediatrics regarding physical, emotional, social, school and psychosocial functioning.

Pendahuluan : Supraventricular tachycardia (SVT) merupakan salah satu kelainan irama jantung yang paling sering muncul pada anak. Episode serangan SVT pada anak sering berulang dan jika tidak dikenali dengan baik dapat mengancam nyawa. Kasus ini melaporkan kejadian SVT pada anak serta manajemen yang dilakukan dengan ditunjang telaah pustaka

Laporan Kasus : Laki-laki usia 1 tahun datang ke ke rumah sakit dengan keluhan berdebar disertai peningkatan pulsasi nadi karotis dan keringat dingin sejak 30 menit sebelum masuk rumah sakit. Pasien memiliki riwayat kardiomiopati dilatasi dan sempat mengalami keluhan yang sama pada usia 6 bulan. Pada pemeriksaan fisik didapatkan tensi 97/68 mmHg, nadi 235x/m, laju napas 32x/m disertai dengan akral dingin. Pada EKG ditemukan gambaran SVT. Tatalaksana awal non-farmakologi dilakukan dengan vagal manuver yaitu pemijatan sirkular di area sinus karotis selama 10 detik dan dilanjutkan dengan kompres es selama 10 detik. Dilakukan kardioversi farmakologis dengan amiodaron dan dilanjutkan terapi rumatan amiodaron. Dilakukan pemeriksaan penunjang rontgen thorax dan echocardiografi pada pasien.

Kesimpulan : Untuk menegakkan diagnosis SVT,  anamnesis terperinci dan pemeriksaan fisik sangat penting untuk dilakukan. EKG dan ekokardiografi harus dilakukan pada anak yang diduga menderita SVT. Keberhasilan eliminasi SVT menghasilkan peningkatan kualitas hidup pediatrik mengenai fungsi fisik, emosional, sosial, sekolah dan psikososial.

Introduction: Thyroid storm is a life-threatening complication of acute hyperthyroidism. The diagnosis of thyroid storm can only be based on its clinical manifestations, which include decreased consciousness, high fever, heart failure, diarrhea and jaundice. Antithyroid drug therapy (ATD) is one option for treating hyperthyroidism, along with surgery and radioactive iodine. ATD is thought to cause neutropenia through the agranulocytosis pathway. The most common symptoms are fever and sore throat accompanied by symptoms of a thyroid crisis. There is no specific method for predicting the appearance of febrile neutropenia caused by ATD. Routine complete blood counts in patients taking ATD should be performed. The diagnosis of febrile neutropenia due to ATD needs to be done immediately so that timely intervention can be carried out and reduce mortality.

Case Presentation: a 25 years old female with thyroid crisis and febrile neutropenia. Clinical findings in the patient include fever, decreased consciousness, palpitation, excessive sweat, diarrhea, nausea and vomiting, weight loss, and the laboratory findings of leukopenia and neutropenia of (leucocyte 1.03x103/uL, neutrophil 1.90x103/ul). Ultrasonography examination of the thyroid reveals a thyroiditis image with multiple solid nodules. Blood smear examination reveals leukopenia with differential count examination of blood showed neutropenia, moderate lymphocytosis, erythrocyte hypochromic micrositer, poikilocytosis ovalocyte, teardrop cell, fragmentosist and target cell. Polychromasia and normoblast cells are not found.

Conclusion: Thyroid crisis refers to the clinical findings and thyroid hormone test results. There is no specific method to predict the appearance of febrile neutropenia caused by the antithyroid drug. Frequent blood tests must be done in patients who consume antithyroid drugs.

Introduction: Acute deep vein thrombosis is a common cause of morbidity and mortality. Venous thrombosis commonly involves the lower extremities, including the iliac veins, femoral veins and vena cava. Optimal therapy of deep vein thrombosis, both ileofemoral and central can prevent complications.

Case Presentation: A 51 years old man complained of swelling of his right leg accompanied by acute pain. On duplex ultrasonography examination, there was a venous thrombosis in the iliofemoral area descending from the common iliac vein to the deep femoral vein. Endovascular venous mechanical thrombectomy was immediately performed because the symptoms were acute, and signs of swelling and pain intensity did not improve. An 8-F catheter was inserted into the patient's right distal superficial femoral vein under ultrasound guidance after administration of intravenous heparin. The CAT8 was inserted through the 8-F sheath and found the thrombus, then vacuum thrombectomy was performed. Swelling and pain disappeared a few hours after the procedure, and the patient was discharged 2 days later.

Conclusion: The Indigo CAT 8 mechanical aspiration thrombectomy system can be an effective treatment modality for patients with acute iliofemoral or central deep vein thrombosis.

Latar Belakang: Trombosis vena dalam akut adalah penyebab umum morbiditas dan mortalitas. Trombosis vena umumnya melibatkan ekstremitas bawah, termasuk vena iliaka, vena femoralis, dan vena cava. Terapi optimal trombosis vena dalam, baik ileofemoral maupun sentral dapat mencegah komplikasi.

Presentasi Kasus: Seorang laki-laki 51 tahun mengeluh kaki kanan bengkak disertai nyeri akut. Pada pemeriksaan ultrasonografi dupleks, terdapat trombosis vena di daerah iliofemoral turun dari vena iliaka komunis ke vena femoralis dalam. Trombektomi mekanik vena endovaskular segera dilakukan karena gejalanya akut, dan tanda pembengkakan serta intensitas nyeri tidak membaik. Kateter 8-F dimasukkan ke dalam vena femoralis superfisial distal kanan pasien di bawah panduan ultrasonografi setelah pemberian heparin intravena. Kateter CAT8 dimasukkan melalui selubung 8-F dan ditemukan trombus, kemudian dilakukan trombektomi vakum. Bengkak dan nyeri menghilang beberapa jam setelah prosedur, dan pasien dipulangkan 2 hari kemudian.

Simpulan: Sistem trombektomi aspirasi mekanik Indigo CAT 8 dapat menjadi modalitas pengobatan yang efektif untuk pasien dengan trombosis vena dalam sentral atau iliofemoral akut.

Introduction: Breast cancer is the most prevalent form of malignancy in women, with over two million new cases yearly. The complex instance of advanced breast cancer with visceral crisis occurs when cancer has spread to vital organs such as the liver, lungs, and brain. This case report aims to teach us how to prevent visceral crisis, which will increase mortality, particularly in advanced breast cancer.

Case presentation: A 50-year-old woman who presented with complaints of shortness of breath was diagnosed with advanced breast cancer and visceral crisis. On examination, there were indications of hypervolemia, including a rightward displaced trachea and diminished vocal fremitus. The anatomical pathology results revealed a grade II invasive breast carcinoma. (Luminal B HER2 negative). X-rays of the chest reveal bilateral pleural effusion. The lumbosacral X-ray and abdominal ultrasonography both revealed liver metastases. Before intra-thoracic metastases and visceral crisis, the patient received hormonal therapy (tamoxifen). When intra-thoracic metastases and visceral problems occurred, the treatment was substituted with capecitabine for 3 months. However, capecitabine was discontinued because the cancer spread to the bones and liver. Patients were administered chemotherapy using docetaxel following NCCN and ESMO guidelines. The patient perished during chemotherapy with docetaxel due to complications from the disease and adverse effects.

Conclusion: Patients with advanced breast cancer who are not appropriately treated run a high risk of developing visceral crisis complications. Therefore, it is crucial that clinicians provide education about routine examinations and adhere to established evaluation procedures in order to prevent these complications.

Latar Belakang: Kanker payudara adalah jenis keganasan yang paling umum terjadi pada wanita dengan lebih dari dua juta kasus per tahun. Kanker payudara stadium lanjut dengan krisis viseral merupakan kasus yang kompleks, dimana kanker menyebar ke organ vital seperti hati, paru-paru dan otak. Tujuan diangkatnya laporan kasus ini adalah menjadi pembelajaran bagi kita bagaimana upaya untuk mencegah kondisi krisis viseral terutama pada kanker payudara stadium lanjut yang akan meningkatkan mortalitas.

Presentasi kasus: Seorang perempuan berusia 50 tahun datang dengan keluhan sesak nafas, pasien terdiagnosa kanker payudara stadium lanjut dengan krisis viseral. Pada pemeriksaan didapatkan adanya tanda-tanda hipervolemia, trakea terdorong ke kanan, penurunan fremitus vokal. Hasil patologi anatomi didapatkan gambaran invasive carcinoma mammae grade II. (Luminal B HER2 negative). Gambaran rontgen thorax menunjukkan adanya efusi pleura bilateral. Hasil rontgen lumbosakral didapatkan metastasis ke tulang dan pada ultrasonografi abdomen didapatkan metastasis hati. Sebelumnya pasien mendapatkan terapi hormonal (tamoxifen), dan pada saat terjadi metastasis intra thoracal serta krisis viseral terapi diganti dengan capecitabine selama 3 bulan namun terjadi progresifitas berupa penyebaran ke tulang dan hati, selanjutnya capecitabine dihentikan. Pasien diberikan kemoterapi berupa docetaxel sesuai guidelines pada NCCN dan ESMO. Selama masa kemoterapi menggunakan docetaxel akhirnya pasien meninggal dunia akibat komplikasi penyakit dan efek samping.

Kesimpulan: Pasien yang menderita kanker payudara stadium lanjut dapat mengalami komplikasi krisis viseral yang berisiko tinggi jika tidak ditangani dengan tepat. Oleh karena itu, laporan kasus ini sangat penting bagi klinisi untuk memberikan edukasi tentang pemeriksaan rutin dan mematuhi prosedur evaluasi yang ditetapkan guna mencegah terjadinya komplikasi tersebut.

Background: Nowadays, there are a lot of treatment options available for dry eye syndrome (DES) or disease (DED). Autologous Serum Eye Drops (ASEDs) is one of the options that offer a potential advantage over conventional therapy. Biochemical elements in ASEDs resemble real tears and act as a lacrimal substitute to provide lubrication. As a severe dry eye treatment, using ASEDs has grown in favor.

Aim: This review aims to deliver knowledge from the current literature on applying ASEDs for dry eye disease in the medical worker.

Method: The method used was a literature review. A comprehensive search was performed on Pubmed and Google Scholar databases in December 2022 using each of the following keywords “ASEDs”, “serum”, “eyedrop”, “DED” and “DES”.

Conclusion: Dry eye disease is incurable and symptom management is the focus of therapy.     Studies have shown that ASEDs reduced dry eye symptoms in over 60% of patients by inhibiting the release of inflammatory cytokines and increasing the number of goblet cells and mucin expression in the conjunctiva. The serum eye drop is typically well tolerated and can be one of the best treatment options for severe DED due to its close resemblance to tears, preservatives free and minimum side effects. 

Collaboration is needed to provide comprehensive services in dealing with complex health problems. However, collaboration in the world of health in Indonesia is still not optimal. So early learning is needed to increase the effectiveness of collaboration, one of which is by organizing interprofessional education (IPE). IPE is a collaborative learning process that involves educators and students from two or more health professions and basic disciplines. IPE can provide various benefits, including training cooperation, communication, leadership, and respect for other professions. With the implementation of the IPE program since college, it is hoped that it will be a provision for students when carrying out professional activities. This study aims to assess communication and teamwork's ability to implement IPE. The method in this study was a literature review, with 19 articles that met the inclusion criteria. Based on a review of several literatures, it was found that implementing IPE can improve communication skills and teamwork.

Dalam menghadapi permasalahan kesehatan yang kompleks, diperlukan kolaborasi guna memberikan pelayanan yang komprehensif. Namun, kolaborasi di dunia kesehatan Indonesia masih belum maksimal. Sehingga diperlukan pembelajaran sejak dini untuk meningkatkan efektivitas kolaborasi, salah satunya dengan penyelenggaraan interprofessional education (IPE). IPE merupakan proses pembelajaran kolaboratif yang melibatkan pendidik dan peserta didik dari dua atau lebih profesi kesehatan dan disiplin dasar. IPE dapat memberikan berbagai manfaat mulai dari melatih kerjasama, komunikasi, kepemimpinan, dan menghormati profesi lain. Dengan penerapan program IPE sejak kuliah, diharapkan dapat menjadi bekal mahasiswa saat menjalani kegiatan profesi. Penelitian ini bertujuan untuk menilai kemampuan komunikasi dan kerjasama tim dalam pelaksanaan IPE. Metode pada studi ini adalah tinjauan literatur, dengan 19 artikel yang memenuhi kriteria inklusi. Berdasarkan kajian terhadap beberapa literatur, didapatkan bahwa pelaksanaan IPE dapat meningkatkan kemampuan komunikasi dan kerjasama tim.

Background: Low irisin levels, a marker widely reported to be associated with developing insulin resistance and type 2 diabetes mellitus. This study aims to provide evidence regarding irisin levels in patients newly diagnosed with type 2 diabetes mellitus.

Methods: A systematic review and meta-analysis of observational studies in adults over 18 newly diagnosed with type 2 diabetes mellitus. The databases used for this study were PubMed, ProQuest and ScienceDirect. Only English studies were considered in the database searched from the beginning to October 2022. The data obtained were analyzed using the RevMan 5.4 application.

Results: Twelve studies met the inclusion criteria. These were identified using a total of 1,621 patients with; 880 cases and 741 controls. This main point shows that the serum irisin level in patients newly diagnosed with type 2 diabetes mellitus has a mean difference of -7.72 with 95% CI -9.49 to -5.95. Since the evidence collected in our meta-analysis showed heterogeneity (I2 = 99%), a random effects model was performed. The z-test results for the overall effect were statistically significant (P≤0.001).

Conclusion: Irisin levels were significantly lower in patients newly diagnosed with type 2 diabetes mellitus than in the healthy group.

The mediastinum is an anatomical space between the lungs that houses the thymus, heart, great vessels, lymph nodes, nerves, and parts of the esophagus and trachea. One of the biggest problems of the mediastinal cavity is mediastinal tumors. Mediastinal tumors have a wide variety of clinical conditions. Difficulties in diagnosing masses in the anterior mediastinal caused by non-specific symptoms and various etiologies can make it difficult to determine the best management for patients. Some masses in the anterior mediastinum that need to be known are thymoma, lipoma, lymphangioma, carcinoma and adenoma. This article aims to describe the various etiologies of masses in the anterior mediastinum along with the management that can be done so that clinicians can provide better treatment.

Mediastinum merupakan sebuah ruang anatomi antara paru-paru yang menampung timus, jantung, pembuluh darah besar, kelenjar getah bening, saraf, dan bagian kerongkongan dan trakea. Salah satu masalah terbesar dari rongga mediastinum yaitu tumor mediastinum. Tumor mediastinum memiliki keragaman yang luas dari kondisi klinis penyakit. Kesulitan dalam mendiagnosis massa pada mediastinal anterior disebabkan oleh gejala yang tidak spesifik dan etiologi yang beragam dapat menjadi penyulit dalam menentukan tatalaksana terbaik bagi pasien. Beberapa massa di mediastinum anterior yang perlu diketahui ialah timoma, lipoma, limfangioma karsinoma dan adenoma. Artikel ini bertujuan untuk memaparkan berbagai etiologi dari massa di mediastinum anterior disertai tatalaksana yang dapat dilakukan sehingga klinisi dapat memberikan penanganan yang lebih baik.

Background: The bioactive compounds material sourced from cinnamon has many benefits, especially as a medicinal ingredient. Therefore, this material has enormous potential to be developed in the future as a raw material for medicine. However, due to its hydrophobic nature, low chemical stability, easily degraded, and has relatively large particle size, its use is constrained. To overcome these problems, emulsifying of these bioactive compounds with a surfactant and making it nanometer in size, has been carried out.

Method: The cinnamon bark bioactive compounds nanoparticles were synthesized by spontaneous emulsion technique using tween 80 surfactant in a cylindrical chamber with a diameter of 500 μm and a length of 50 cm.

Results: The bioactive compounds contained in cinnamon bark are: (1) cinnamaldehyde (68%), (2) bornylester of acrylic acid (10,31%), (3) alpha-copaene (3,32%), (4) cumarine (12,30%), and (5) methyl isoheptadecanoate (5.25%). Synthesized using four different concentrate masses of these compounds, namely: 4 mg, 6 mg, 8 mg and 10 mg dissolved in 100 ml of ethanol, resulting in an average nanoparticle diameter of: 11.0 nm; 12.1nm; 12.5nm; and 13.9 nm. The polydispersity indices of the synthesized nanoparticles in each synthesis process are 0,292; 0,300; 0,215; dan 0,313.

Conclusion:  From the data obtained, it shows that the greater the mass of the concentrate used, the greater the average diameter of the resulting nanoparticles. The relationship is linear. The same thing happened to the polydispersity index. The value of the polydispersity index increases when the concentrate mass used increases.

Latar Belakang: Material senyawa bioaktif yang bersumber dari kulit kayu manis (cinnamon) memiliki banyak manfaat terutama sebagai bahan obat-obatan. Oleh karena itu material senyawa bioaktif ini memiliki potensi yang sangat besar untuk dikembangkan ke depan sebagai bahan baku obat. Namun, karena sifatnya yang hidrofobik, stabilitas kimianya yang rendah, mudah terdegradasi, dan ukuran partikelnya yang relatif besar, penggunaannya mengalami kendala. Untuk mengatasi masalah ini suatu pendekatan mengemulsi senyawa bioaktif tersebut dengan suatu surfaktan dan membuat ukurannya berorde nanometer, telah dilakukan.

Metode: Untuk menghasilkan partikel senyawa bioaktif kulit kayu manis berukuran nanometer, sintesa dengan teknik emulsi spontan dengan menggunakan surfaktan tween 80, telah dilakukan di dalam suatu ruang berbentuk tabung berdiameter 500 μm dan panjang 50 cm.

Hasil: Dari hasil identifikasi, senyawa bioaktif yang terkandung di dalam kulit kayu manis adalah: (1) cinnamaldehyde (68%), (2) bornylester of acrylic acid (10,31%), (3) alpha-copaene (3,32%), (4) cumarine (12,30%), dan (5) methyl isoheptadecanoate (5,25%). Sintesa dengan menggunakan empat ragam massa konsentrat dari senyawa-senyawa tersebut, yaitu: 4 mg, 6 mg, 8 mg dan 10 mg yang dilarutkan ke dalam 100 ml etanol, menghasilkan diameter rata-rata nanopartikel masing-masing sebesar 11,0 nm; 12,1 nm; 12,5 nm; dan 13,9 nm. Indeks polidispersitasnya masing-masing sebesar 0,292; 0,300; 0,215; dan 0,313.

Simpulan: Dari data yang diperoleh menunjukkan bahwa semakin besar massa konsentrat yang digunakan, semakin besar pula diameter rata-rata nanopartikel yang dihasilkan. Hubungannya bersifat linier. Hal yang sama terjadi pada indeks polidispersitasnya. Nilai indeks polidispersitas semakin besar ketika massa konsentrat yang digunakan semakin besar.

Introduction: One of the mandatory health protocols during the COVID-19 pandemic is wearing a mask. Masks that are used for a long time can increase the risk of developing acne vulgaris in the area around the mouth and nose (mask acne). The impact caused by acne masks is very detrimental both in terms of aesthetics, comfort, and psychology. This study aims to analyze the prevalence and risk factors for mask acne in undergraduate medical students and the medical profession at Udayana University class of 2019-2021.

Methods: This study has a cross-sectional design with observational analytic methods. The sample of this research was 260 respondents who were taken by consecutive sampling. Data analysis was performed by chi-square test and logistic regression.

Results: The prevalence of mask acne in students of the Faculty of Medicine, Udayana University class of 2019-2021 is 50.8%. Risk factors for mask acne in students of the Faculty of Medicine, Udayana University class of 2019-2021 include skin type (p = 0.025), oily skin condition after using a mask (p <0.001), and having a history of acne vulgaris due to sunlight (p = 0.002).

Conclusion: About half of the 2019-2021 class of Udayana University Faculty of Medicine students experience mask acne with various risk factors.

Pendahuluan: Salah satu protokol kesehatan saat pandemi COVID-19 yang wajib dilakukan adalah menggunakn masker. Masker yang digunakan dalam waktu lama dapat meningkatkan risiko timbulnya acne vulgaris di area sekitar mulut dan hidung (mask acne). Dampak yang ditimbulkan mask acne sangat merugikan baik dari segi estetika, kenyamanan, dan psikologis. Penelitian ini memiliki tujuan untuk menganalisis prevalensi dan faktor risiko mask acne pada mahasiswa program studi sarjana kedokteran dan profesi dokter Universitas Udayana angkatan 2019-2021.

Metode: Penelitian ini memiliki desain cross-sectional dengan metode analitik observasional. Sampel dari penelitian ini sebanyak 260 responden yang diambil dengan cara consecutive sampling. Analissi data dilakukan dengan uji chi-square dan regresi logistik.

Hasil: Prevalensi mask acne pada mahasiswa Fakultas Kedokteran Universitas Udayana angkatan 2019-2021 adalah 50,8%. Faktor risiko mask acne pada mahasiswa Fakultas Kedokteran Universitas Udayana angkatan 2019-2021 antara lain jenis kulit (p = 0,025), kondisi kulit berminyak setelah menggunakan masker (p<0,001), dan memiliki riwayat acne vulgaris akibat sinar matahari (p = 0,002).

Simpulan: Sekitar setengah dari jumlah mahasiswa Fakultas Kedokteran Universitas Udayana angkatan 2019-2021 mengalami mask acne dengan berbagai faktor risiko.

Background: Diabetes mellitus (DM) is still one of the most feared diseases and is the number three disease with the highest mortality risk globally. One of the risk factors for the occurrence of type 2 DM is bad eating habits that lead to obesity, which is the factor that tends to cause type 2 DM. Therefore, this study aims to know diet as a risk factor for type 2 diabetes mellitus in college students.

Methods: This research was conducted at the Faculty of Medicine, Udayana University, from September to November 2022, using a cross-sectional descriptive method. The primary data source was collected using a questionnaire. Data were analyzed univariately using the original SPSS version 25.

Results: Total of 247 respondent was include in this research. It was found that the majority of respondents were women aged 19 years with a good level of knowledge (91.5%) and good attitudes (81.4%) regarding diet as a risk factor for type 2 DM, and had the habit of regularly eating three times a day (66,8%). 

Conclusion: Undergraduate medical students in the faculty of medicine at Udayana University class of 2021 have a good level of knowledge and attitudes towards diet as a risk factor for type 2 DM, and the behavior of regularly eating three times a day.

Latar belakang: Penyakit diabetes melitus (DM) sampai sekarang masih menjadi salah satu penyakit yang paling ditakuti dan merupakan penyakit nomor tiga yang paling berisiko tinggi tingkat mortalitasnya di dunia. Salah satu faktor risiko terjadinya DM tipe 2 adalah kebiasaan pola makan yang salah sehingga menimbulkan obesitas yaitu salah satu faktor kecenderungan terjadinya DM tipe 2. Studi ini bertujuan mengetahui pola makan sebagai faktor risiko diabetes melitus tipe 2 pada mahasiswa.

Metode: Penelitian ini dilakukan di Fakultas Kedokteran Universitas Udayana pada bulan September hingga November 2022 menggunakan metode deskriptif potong lintang dan sumber data yaitu data primer yang dikumpulkan menggunakan kuesioner. Data dianalisis secara univariat menggunakan aplikasi SPSS versi 25 original.

Hasil: Terdapat total 247 responden yang termasuk dalam penelitian ini. Didapatkan bahwa mayoritas responden merupakan perempuan dan berusia 19 tahun dengan tingkat pengetahuan baik (91,5%) dan sikap baik (81,4%) terhadap pola makan sebagai faktor risiko DM tipe 2, serta memiliki perilaku teratur makan tiga kali sehari (66,8%).

Kesimpulan: Mahasiswa PSSK FK UNUD angkatan 2021 memiliki tingkat pengetahuan serta sikap yang baik terhadap pola makan sebagai faktor risiko DM tipe 2, dan perilaku teratur makan tiga kali sehari.

Introduction: The high mortality rate due to pelvic fractures in Indonesia requires the latest data regarding case descriptions related to the causes of pelvic fracture incidents, treatment and complications that can be caused.

Methods: The study design is a retrospective descriptive study with a cross-sectional approach. The sample population was determined by total sampling, namely all patients with pelvic fractures who received treatment at the ER of Prof. Dr. I.G.N.G Nogerah Denpasar. All data were taken from medical records and then analyzed descriptively. The independent variables in this study were age, gender, mechanism of injury, classification of Young-Burges and Tile fractures, emergency management of pelvic fractures and acute complications experienced. While the dependent variable was the incidence of pelvic fractures.

Results: A total of 75 samples of pelvic fracture cases were obtained for the period January 2019 to September 2022. Men dominated the majority of pelvic fracture cases at Prof. Dr. I.G.N.G Ngoerah from January 2019 – September 2022 with a proportion of 64%. Most of the cases were adults aged 25-59 years (66.67%) with the mechanism of injury most often caused by traffic accidents (77.3%). Most cases of pelvic fractures that occur fall into the category of stable pelvic fractures with the Young Burges APC II classification (18.7%) and the Tile A1 classification (14.7%). More than half of the cases (58.7%) of pelvic fractures were treated operatively with the most common procedure being ORIF PS (90.9%). There were 14 cases that experienced acute complications, where most cases of pelvic fractures were accompanied by internal organ injuries (64.3%) and hypovolemic shock (71.4%).

Conclusion: Most pelvic fracture cases at Prof. Dr. I.G.N.G Ngoerah Denpasar Hospital was treated operatively and 19% of them experienced acute complications. Future studies should focus on tracing the causes of acute complications that occur to achieve more effective and efficient management of pelvic fracture cases.

Pendahuluan: Tingginya angka mortalitas akibat fraktur pelvis di Indonesia membutuhkan data terbaru terkait gambaran kasus yang berhubungan dengan penyebab kejadian insiden fraktur pelvis, penanganan serta komplikasi yang dapat disebabkan. 

Metode: Desain studi yaitu penelitian deskriptif retrospektif dengan pendekatan potong lintang. Populasi sampel ditentukan secara total sampling yaitu seluruh pasien dengan fraktur pelvis yang mendapatkan penanganan di UGD RSUP Prof. Dr. I.G.N.G Nogerah Denpasar. Seluruh data diambil dari rekam medis dan kemudian dianalisis secara deskriptif. Variabel bebas dalam penelitian ini adalah usia, jenis kelamin, mekanisme cidera, klasifikasi fraktur Young-Burges dan Tile, penanganan darurat fraktur pelvis dan komplikasi akut yang dialami. Sementara variabel tergantung adalah kejadian fraktur pelvis.

Hasil: Sebanyak 75 sampel kasus fraktur pelvis didapatkan untuk periode Januari 2019 hingga September 2022. Laki-laki mendominasi sebagian besar kasus fraktur pelvis di RSUP Prof. Dr. I.G.N.G Ngoerah dari Januari 2019 – September 2022 dengan proporsi 64%. Sebagian besar kasus merupakan orang dewasa berusia 25-59 tahun (66,67%) dengan mekanisme cidera yang paling sering disebabkan oleh kecelakaan lalu lintas (77,3%). Sebagian besar kasus fraktur pelvis yang terjadi masuk dalam kategori fraktur pelvis stabil dengan klasifikasi Young Burges APC II (18,7%) dan klasifikasi Tile A1 (14,7%). Lebih dari setengah jumlah kasus (58,7%) fraktur pelvis ditangani secara operatif dengan tindakan yang paling sering adalah ORIF PS (90,9%). Terdapat sebanyak 14 kasus yang mengalami komplikasi akut, dimana sebagian besar kasus fraktur pelvis disertai dengan cidera organ dalam (64,3%) dan syok hipovolemik (71,4%).

Simpulan: Kasus fraktur pelvis di RSUP Prof. Dr. I.G.N.G Ngoerah Denpasar sebagian besar ditangani secara operatif dan 19% diantaranya mengalami komplikasi akut, studi selanjutnya agar dapat fokus pada penelusuran penyebab komplikasi akut yang terjadi untuk mencapai tatalaksana kasus fraktur pelvis yang lebih efektif dan efisien.

Background: Pseudomonas aeruginosa is a gram-negative bacterium that is commonly associated with Healthcare-Associated infections (HAI), particularly Multidrug-resistance (MDR) P. aeruginosa. The polyphenolic compounds found in the peel of pomelo (C. maxima) are reported to have shown an effective antimicrobial effect. Therefore, this study aimed to investigate the inhibitory effect of C. maxima peel essential oil on the growth of P. aeruginosa bacteria.

Methods: This in vitro study evaluates the inhibitory effect of C. maxima peel essential oil against clinical isolate strains (SP47) and MDR P. aeruginosa by measuring the diameter of the inhibition zone (mm). Five series of essential oil concentrations (20%, 40%, 60%, 80%, and 100%) and the control group were used in the paper disk diffusion test with three repetitions (triplet). All data were statistically analyzed using SPSS ver. 20.

Results: A total of 4.85 mL of essential oil from 7.2 kg of C. maxima fruit peel was obtained. Inhibition zones were observed in clinical isolates of P. aeruginosa by concentrations of 60%, 80%, 100%, and K+ with means of 6.27±0.08 mm; 6.71±0.19 mm; 9.08±0.29 mm; and 40.8±0.48 mm, respectively. In MDR P. aeruginosa, the inhibition zone by concentrations of 80%, 100%, and K+ with means of 6.45±0.13 mm; 7.15±0.13 mm; and 9.08±0.34 mm, respectively. There was a significant difference in the mean diameter within groups (p<0.05).

Conclusion: C. maxima fruit peel essential oil was able to inhibit the growth of P. aeruginosa bacteria, both clinical and MDR isolates. There were differences in inhibition between the concentration series.

Metode: Penelitian ini merupakan studi in vitro yang mengevaluasi daya hambat minyak atsiri kulit buah C. maxima terhadap strain isolat klinis (SP47) dan MDR P. aeruginosa melalui pengukuran diameter zona hambat (mm). Sebanyak lima seri konsentrasi minyak atsiri (20%, 40%, 60%, 80%, dan 100%) dan kelompok kontrol digunakan dalam uji paper disk diffusion dengan pengulangan sebanyak tiga kali (triplet) Seluruh data dianalisis secara statistik menggunakan SPSS ver. 20.

Hasil: Sebanyak 4,85 mL minyak atsiri dari 7,2 kg kulit buah C. maxima diperoleh dengan metode destilasi uap. Zona hambat teramati pada isolat klinis P. aeruginosa oleh konsetrasi 60%, 80%, 100%, dan K+ dengan rerata sebesar 6,27±0,08 mm; 6,71±0,19 mm; 9,08±0,29 mm; dan 40,8±0,48 mm berturut-turut. Zona hambat juga teramati pada isolat MDR P. aeruginosa oleh konsetrasi 80%, 100%, dan K+ dengan rerata sebesar 6,45±0,13 mm; 7,15±0,13 mm; dan 9,08±0,34 mm berturut-turut. Terdapat perbedaan rerata diameter yang signifikan antar kelompok uji (p<0,05).

Simpulan: Minyak atsiri kulit buah C. maxima mampu menghambat pertumbuhan bakteri P. aeruginosa baik isolat klinis maupun MDR. Adapun terdapat perbedaan daya hambat antar seri konsentrasi.

Kata kunci: antimikroba, citrus maxima, minyak atsiri, multidrug resistant

Background: Protein is an essential macronutrient that contains essential components. Protein plays a crucial role in the growth and development of children. Imbalance between protein requirements and protein intake can lead to stunting in children.

Objective: To determine the relationship between animal protein intake in children aged 1-5 years who experience stunting in the working environment of Nagi Public Health Center in Larantuka City.

Methods: This study was a cross-sectional study. Data were obtained from primary data, and questionnaires were distributed consisting of three main parts, including the characteristics of the research sample, nutritional intake of the research sample, and eating habits of the research sample. Protein intake in this study was calculated using nutritional survey. Chi-square was used as the statistical test. Comparative categorical Chi-square analysis was also performed with the independent variable of animal protein intake pattern and the dependent variable of stunting.

Results: A total of 124 children who met the inclusion criteria were included in this study. The results of this study showed that among all respondents who experienced stunting, 78.3% had an animal protein intake pattern of <2 times/week. This was statistically significant with a p-value <0.01 and confidence interval of 5.16-28.89. Furthermore, among all respondents who experienced stunting, 34.8% had a plant protein intake pattern of <2 times/week. This was not statistically significant with a p-value >0.01 and confidence interval of 0.651-1.809. The results of multivariate analysis with logistic regression showed that only animal protein consumption variable showed a significant association with stunting with an odds ratio (OR) of 76.6 and 95% confidence interval (CI) of 20.4-291.7.

Conclusion: Animal protein intake has a greater influence on the occurrence of stunting compared to plant protein intake.

Latar Belakang: Protein merupakan makronutrien penting yang mengandung komponen esensial. Protein berperan penting dalam pertumbuhan dan perkembangan anak. Tidak seimbangnya antara kebutuhan protein dengan asupan protein menyebabkan terjadinya stunting pada anak. 

Tujuan: Menentukan hubungan asupan protein hewani pada anak usia 1-5 tahun yang mengalami stunting di lingkungan kerja Puskesmas Nagi Kota Larantuka.

Metode: Penelitian ini merupakan penelitian cross-sectional. Data berasal dari data primer kemudian dilakukan penyebaran kuesioner yang terdiri atas 3 bagian utama yang mencakup karakteristik sampel penelitian, asupan nutrisi sampel penelitian serta kebiasaan makan dari sampel penelitian. Cara menghitung asupan protein pada penelitian ini dengan menggunakan nutritional survey. Uji statistik yang digunakan adalah Chi-square. Kemudian dilakukan juga analisis komparatif kategorik Chi-square dengan variabel independen pola asupan protein hewani dan variabel dependent berupa stunting.

Hasil: Sebanyak 124 anak yang memenuhi kriteria inklusi diikutsertakan dalam penelitian ini. hasil studi ini menunjukkan bahwa dari semua responden yang mengalami stunting, sebanyak 78,3% memiliki pola asupan protein hewani <2x/minggu. Hal ini signifikan secara statistik dengan nilai p<0,01 dan interval kepercayaan 5,16-28,89, kemudian dari semua responden yang mengalami stunting, sebanyak 34,8% memiliki pola asupan protein nabati <2x/minggu. Dimana hal ini tidak signifikan secara statistik dengan nilai p>0,01 dan interval kepercayaan 0,651-1,809. Hasil uji analisis multivariat dengan regresi logistik, hanya variabel konsumsi protein hewani yang menunjukkan hubungan yang bermakna terhadap stunting dengan (OR 76,6 95% CI 20,4-291,7).

Simpulan: Asupan protein hewani lebih berpengaruh terhadap terjadinya stunting dibandingkan asupan protein nabati.

Background: Melasma or chloasma is a condition of hyperpigmentation of the skin, especially the facial area which is commonly found in women due to exposure to ultraviolet (UV) and hormonal influences. The development of melasma disease is generally evaluated using oxidative parameters that reflect conditions of oxidative stress and accumulation of ROS in the skin. 4 Hydroxinonenal (4-HNE) is a photo-oxidation product that is more stable than other ROS groups and can represent the condition of cyanocytes and melanocytes in the skin.

Method: Analytical observational study with a cross-sectional approach. The research was carried out from October – December 2022 at the Dermatology and Venereology Polyclinic and Clinical Pathology Laboratory, Sanglah Hospital Denpasar. The sample consisted of 40 melasma samples and 20 non-melasma samples aged 18-65 years who were selected through consecutive sampling according to inclusion and exclusion criteria. The sample is taken by taking 3 milliliters of venous blood which will then be examined for 4-HNE with an ELISA kit. Data analysis was carried out using SPSS version 23 and the value of p <0.05 was significant.

Results: The results of the analysis showed that the group with melasma had significantly higher levels of 4-HNE (765.22±243.65 ng/mL) compared to the non-melasma group (347,68±110,99 ng/mL). The results of the correlation analysis showed that there was a significant correlation between 4-HNE levels and the MASI score with a correlation coefficient (r) of 0.955 and a p-value of 0.000.

Conclusion: The mean 4-HNE level in melasma group was significantly higher when compared to non-melasma group. 4-HNE levels were significantly correlated and directly proportional to the severity of melasma as measured by the MASI score.

Latar Belakang: Melasma atau chloasma merupakan suatu kondisi hiperpigmentasi pada kulit, khususnya daerah wajah yang umumnya ditemukan pada wanita akibat adanya paparan sinar ultraviolet (UV) dan pengaruh hormonal. Perkembangan penyakit melasma umumnya dievaluasi menggunakan parameter oksidatif yang mencerminkan kondisi stres oksidatif dan akumulasi ROS pada kulit. 4 Hidroksinonenal (4-HNE) merupakan photo-oxidation product yang bersifat lebih stabil dibandingkan golongan ROS lainnya dan dapat merepresentasikan kondisi keranosit dan melanosit pada kulit.

Metode: Studi observasional analitik dengan pendekatan potong lintang. Penelitian dilaksanakan mulai bulan Oktober - Desember 2022 di Poliklinik Kulit dan Kelamin dan Laboratorium Biomedik Terpadu Fakultas Kedokteran Universitas Udayana. Sampel terdiri dari 40 sampel melasma dan 20 sampel bukan melasma yang berusia 18-65 tahun yang dipilih melalui consecutive sampling sesuai kriteria inklusi dan eksklusi. Sampel dilakukan pengambilan 3 mililter darah vena yang kemudian akan diperiksa 4-HNE dengan kit ELISA. Analisis data dengan SPSS versi 23 dan nilai p<0.05 bermakna signifikan.

Hasil: Hasil analisis menunjukkan bahwa kelompok dengan melasma secara signifikan memiliki kadar 4-HNE yang lebih tinggi (765,22±243,65 ng/mL) dibandingkan dengan kelompok non-melasma (347,68±110,99 ng/mL). Hasil analisis korelasi menunjukkan bahwa korelasi yang signifikan antara kadar 4-HNE dengan skor melasma area and severity index (MASI) dengan nilai koefisien korelasi (r) sebesar 0,955 dan nilai p sebesar 0,000.

Kesimpulan: Rerata kadar 4-HNE pada kelompok melasma secara signifikan lebih tinggi jika dibandingkan dengan kelompok non-melasma. Kadar 4-HNE berkorelasi secara signifikan dan berbanding lurus dengan tingkat keparahan melasma yang diukur dengan skor MASI.

Introduction: Problem-based learning is a method of approach in assisting students in finding problems from a real event. This can affect learning methods to increase skills of critical thinking and active learning, where critical thinking will encourage the formation of knowledge and will be interpreted personally and will be applied to conditions or problems so as to increase active learning. This study aims to determine association between critical thinking skills towards active learning in medical students at Universitas Udayana.

Methods: The respondents of this study were medical students class 2020 in Universitas Udayana. The type of this research is analytic research with a cross-sectional approach. The sampling technique used was the total sampling method and used a questionnaire of critical thinking and active learning.

Results: A total of 165 respondents met the inclusion criteria in this research. The analysis results showed that critical thinking skills increased active learning significantly (p < 0.001) with moderate and direct correlation (r = 0.574).

Conclusion: The ability to think critically can affect the level of active learning in medical education students.

Pendahuluan: Salah satu metode pendekatan untuk membantu mahasiswa dalam menemukan masalah dari suatu peristiwa yang nyata adalah pembelajaran berbasis masalah. Hal ini dapat mempengaruhi metode belajar yang menyebabkan peningkatan kemampuan berpikir dan keaktifan belajar. Berpikir kritis akan mendorong terbentuknya pengetahuan dan akan diinterpretasi personal dan akan diaplikasikan pada kondisi atau masalah sehingga meningkatkan keaktifan belajar. Penelitian ini memiliki tujuan untuk menganalisis hubungan antara kemampuan berpikir kritis dan keaktifan belajar pada mahasiswa sarjana kedokteran Universitas Udayana.

Metode: Responden penelitian ini adalah mahasiswa program studi sarjana kedokteran Universitas Udayana angkatan 2020. Penelitian ini merupakan penelitian analitik dengan pendekatan potong lintang. Teknik pengambilan sampel dilakukan dengan total sampling dan menggunakan kuesioner berpikir kritis dan keaktifan belajar.

Hasil: Sebanyak 165 responden memenuhi kriteria inklusi dalam penelitian ini.  Hasil analisis menunjukkan bahwa kemampuan berpikir kritis meningkatkan keaktifan belajar secara signifikan (p < 0,001) dengan korelasi sedang dan searah (r = 0,574).

Simpulan: Kemampuan berpikir kritis dapat mempengaruhi tingkat keaktifan belajar pada mahasiswa sarjana kedokteran Universitas Udayana.

Introduction: Indonesian Ministry of Health gave a third dose (booster) which was prioritized by the medical staff within 3 months since the second dose was given. The vaccine used for a booster is mRNA-1273 (Moderna) which had been approved by FDA (Food and Drug Administration) with modality mRNA and considerable efficacy. The adverse reaction to the skin which may present post-Moderna vaccination is a local reaction on the injection site on the first dose and increased on the second dose, delayed large local reaction on the first dose and decreased on the second dose. This study aims to determine the characteristics of dermatological lesions in the co-occurrence of post-COVID-19 booster Moderna vaccination in profession stage students of the Faculty of Medicine, Universitas Mataram, class of 2015-2017.

Method: The research design used was descriptive by taking data from respondents who received the Moderna booster who were students of the Faculty of Medicine, Universitas Mataram, class 2015-2017 and were willing to fill out a questionnaire.

Result: It was found that there were adverse reactions after vaccination as many as 90 respondents of 100 respondents with skin manifestations after Moderna booster vaccination, such as pain in the injection area (84%), edema (40%), erythema of the injection area (27%), itching (8%), urticaria (3%) and angioedema (1%). The onset of most symptoms occurred at 12-24 hours post-injection (33.3%) and 6-12 hours post-injection (23.3%).

Conclusion: There were skin manifestations in most of the respondents who received the Moderna vaccine booster (90%), with the most symptoms onset at 12-24 hours post-injection 33.3%.

Latar Belakang: Kementerian Kesehatan Republik Indonesia memberikan vaksinasi dosis ketiga (booster) yang diutamakan untuk tenaga kesehatan dengan jarak minimal 3 bulan setelah dosis kedua. Pemberian vaksin booster berupa vaksin mRNA-1273 (Moderna) yang diakui oleh FDA (Food and Drug Administration) dengan modalitas mRNA dan memiliki efikasi yang cukup besar. Efek samping pada kulit yang dapat muncul pasca vaksinasi Moderna adalah reaksi lokal pada tempat injeksi pada dosis pertama dan meningkat pada dosis kedua, delayed large local reaction pada dosis pertama dan menurun pada dosis kedua.

Tujuan: Penelitian ini bertujuan untuk mengetahui karakteristik lesi dermatologi pada kejadian ikutan pasca vaksinasi COVID-19 booster Moderna pada mahasiswa tahap profesi Fakultas Kedokteran Universitas Mataram angkatan 2015-2017.

Metode: Desain penelitian yang digunakan adalah deskriptif dengan cara mengambil data dari responden penerima booster Moderna yang merupakan mahasiswa tahap profesi Fakultas Kedokteran Universitas Mataram angkatan 2015-2017 dan bersedia mengisi kuesioner.

Hasil: Dari penelitian yang dilakukan didapatkan adanya kejadian ikutan pasca vaksinasi  sebanyak 90 responden dari 100 responden dengan manifestasi kulit pasca vaksinasi booster Moderna berupa nyeri pada daerah injeksi (84%), edema (40%), eritema daerah injeksi (27%), gatal (8%), urtikaria (3%) dan angioedema (1%). Awitan timbulnya gejala terbanyak pada 12-24 jam pasca injeksi (33,3 %) dan 6-12 jam pasca injeksi (23,3%).

Simpulan: Terdapat manifestasi kulit pada sebagian besar responden yang menerima booster vaksin Moderna (90%) dengan awitan timbulnya gejala terbanyak pada 12 jam-24 jam pasca injeksi sebesar 33,3%.

Background: Mild Cognitive Impairment (MCI) is a mild cognitive function disorder in the form of decreased memory function but does not interfere with daily activities. Decreased memory and impaired orientation of place and time due to MCI will increase the risk of injury in the elderly in their daily lives. Knowing the incidence of MCI earlier is very important, as finding MCI sufferers earlier can inhibit the progression and improve the quality of life of sufferers. Thus, this study aims to determine the incidence of amnestic and non-amnestic MCI in the elderly, especially in the Puskesmas Uabau working area.

Methods: The research design used a cross-sectional method where data was collected by interviewing using the MMSE-Ina questionnaire. A total of 135 subjects consisting of the elderly (45-60 years) and elderly (>60 years) age group in the Puskesmas Uabau working area were included in the study using consecutive random sampling—selection of the sample according to the eligibility criteria. Data analysis was carried out to determine the incidence of amnestic and non-amnestic MCI types.

Results: There was an incidence of MCI of 47.4% (64 people), which was dominated by women in the elderly group >71 years with comorbidities (diabetes mellitus, hyperuricemia, stroke), and did not have comorbid hypertension and dyslipidemia. Single realm amnestic type MCI was obtained as much as 3.1%, plural amnestic type MCI was 57.8%, plural non-amnestic type MCI was 39.1%, and no elderly group was found with single domain non-amnestic type MCI.

Conclusion: The incidence of MCI in the elderly group at the Uabau Health Center is high, so special attention is needed from an early age so as not to fall into a state of more severe cognitive impairment.

Latar Belakang: Mild Cognitive Impairment (MCI) merupakan gangguan fungsi kognitif ringan berupa menurunnya fungsi memori namun tidak mengganggu aktivitas sehari-hari. Menurunnya daya ingat serta gangguan orientasi tempat dan waktu akibat MCI akan meningkatkan risiko kejadian cedera pada kelompok usia lanjut dalam kesehariannya. Mengetahui insiden MCI sejak dini sangatlah penting, dimana ditemukannya penderita MCI sejak dini dapat menghambat progresifitas serta meningkatkan kualitas hidup penderitanya. Dengan demikian, penelitian ini bertujuan untuk mengetahui insidensi dari MCI tipe amnestik dan non-amnestik pada kelompok usia lanjut, khususnya di lingkungan Puskesmas Uabau.

Metode: Desain penelitian menggunakan metode potong lintang dimana pengambilan data dilakukan dengan wawancara menggunakan kuisioner MMSE-Ina. Sebanyak 135 subjek yang terdiri dari kelompok usia prelansia (45-60 tahun) dan lansia (>60 tahun) di wilayah kerja Puskesmas Uabau dimasukkan dalam penelitian menggunakan consecutive random sampling. Pemilihan sampel sesuai dengan kriteria eligibilitas. Analisis data dilakukan untuk mengetahui insiden MCI tipe amnestik dan non amnestik.

Hasil: Didapatkan insiden MCI sebesar 47.4% (64 orang), dimana didominasi oleh perempuan di kelompok lansia >71 tahun dengan komorbid (diabetes melitus, hiperurisemia, stroke), serta tidak memiliki komorbid hipertensi dan dislipidemia. MCI tipe amnestik ranah tunggal didapatkan sebanyak 3.1%, MCI tipe amnestik ranah jamak sebanyak 57.8%, MCI tipe non-amnestik ranah jamak sebanyak 39.1%, dan tidak ditemukan kelompok usia lanjut dengan MCI tipe non-amnestik ranah tunggal.

Kesimpulan: Insiden MCI pada kelompok usia lanjut di Puskesmas Uabau tinggi sehingga dibutuhkan perhatian khusus sejak dini agar tidak jatuh ke keadaan gangguan kognitif yang lebih berat.

Introduction: Hydrocephalus is pathological condition that results in disturbances of formation, flow, and absorption of cerebrospinal fluid (CSF) resulting an increase in the volume of CSF in the brain. The etiology of hydrocephalus is distinguished by congenital and acquired. Hydrocephalus in children have not been widely discussed, especially characteristics of hydrocephalus in children. This study aims to determine the characteristics of hydrocephalus in children at Prof. Dr. I.G.N.G. Ngoerah Hospital Denpasar in 2021-2022.

Methods: This research is a descriptive study using medical record data. This research was conducted at Prof. Dr. I.G.N.G Ngoerah Hospital Denpasar from September to October 2022. The sampling technique used is total sampling.

Result: As many as 73 children with hydrocephalus at Prof. Dr. I.G.N.G. Ngoerah Hospital Denpasar in 2021-2022 with characteristics in the form of congenital hydrocephalus in 41 people (56.2%), the highest age group in infants (0-2 years) as many as 34 people (46.6%), in the boy group as many as 43 people (58.9%) with clinical symptoms of macrocephaly in 43 people (58.9%) and headache in 18 people (24.7%), with management of VP shunt surgery 55 people (75.3%), and patient outcome the most living are 61 people (83.6%).

Conclusion: Children suffering with hydrocephalus at Prof. Dr. I.G.N.G. Ngoerah Hospital Denpasar in 2021-2022 mostly due to a congenital etiology with clinical symptoms of macrocephaly treated with VP shunt surgery and life outcomes in the age range of 0-2 years.

Pendahuluan: Hidrosefalus adalah suatu keadaan patologis yang mengakibatkan adanya gangguan pada pembentukan, aliran, maupun penyerapan cairan serebrospinal (CSS) sehingga terjadi peningkatan volume CSS pada otak. Etiologi hidrosefalus dibedakan berdasarkan kongenital dan acquired (didapat). Kasus hidrosefalus pada anak tersebut belum banyak dibahas khususnya dalam hal karakteristik penderita hidrosefalus pada anak. Tujuan penelitian ini adalah untuk mengetahui karakteristik hidrosefalus pada anak di RSUP Prof. Dr. I.G.N.G. Ngoerah tahun 2021-2022 dari aspek etiologi, klinis, tatalaksana, dan luaran.

Metode: Penelitian ini merupakan penelitian deskriptif menggunakan data rekam medis. Penelitian ini dilaksanakan di RSUP Prof. Dr. I.G.N.G Ngoerah Denpasar pada bulan September sampai Oktober tahun 2022. Adapun teknik sampling yang digunakan adalah total sampling.

Hasil: Ditemukan 73 kasus anak penderita hidrosefalus di RSUP Prof. Dr. I.G.N.G. Ngoerah tahun 2021-2022 dengan karakteristik etiologi berupa hidrosefalus kongenital yaitu 41 orang (56,2%), kelompok usia tertinggi pada bayi (0-2 tahun) berjumlah 34 orang (46,6%), pada kelompok jenis kelamin laki-laki yaitu 43 orang (58,9%) dengan gejala klinis terbanyak makrosefali 43 orang (58,9%) dan nyeri kepala 18 orang (24,7%), dengan tatalaksana berupa bedah VP shunt 55 orang (75,3%), dan luaran terbanyak pasien hidup yaitu 61 orang (83,6%).

Simpulan: Anak penderita hidrosefalus di RSUP Prof. Dr. I.G.N.G. Ngoerah tahun 2021-2022 tinggi pada laki-laki, akibat etiologi kongenital dengan gejala klinis makrosefali yang ditatalaksana dengan bedah berupa VP shunt serta luaran hidup pada rentang usia 0-2 tahun.

Background: Chronic suppurative otitis media (CSOM) is one of the causes of ear disorders in various countries, especially developing countries. The prevalence of CSOM in Indonesia is 3.8% or an estimated 6.6 million Indonesian population. The purpose of this study was to determine the audiometric characteristics of CSOM patients at the ENT Polyclinic, Prof. Dr. I.G.N.G. Ngoerah Hospital in the period of 2018-2019.

Methods: This research used a retrospective descriptive study design. Sampling was carried out by total sampling, namely every patient who met the research inclusion criteria was included in the research sample. The number of samples used are all descriptive data collected on a predetermined period scale in the research design where the study obtained 70 research samples.

Results: There were 33 (47.14%) female and 37 (52.86%) male with CSOM. There were 4 people (5.71%) of CSOM aged ≤ 10 years, 10 (14.29%) aged 11-20 years, 8 (11.43%) aged 21-30 years, 9 (12.86%) aged 31-40 years, 19 (27.14%) aged 41-50 years, 11 (15.71%) aged 51-60 years, 5 (7.14%) aged 61-70 years, 4 (5.71%) aged more than 70 years. Furthermore, 42 people (60%) with CSOM had conductive hearing loss (CHL). 12.86% of patients had sensorineural hearing loss (SNHL), 13 people with CSOM had mild deafness (22.86%), 13 people had moderate deafness (34.29%), 24 people had moderate-severe deafness (28.57%), 20 people had severe deafness (28.6%), 8 people had very severe deafness (11.46%).

Conclusion: The proportion of CSOM patients in the ENT polyclinic at RSUP Prof. Dr. I.G.N.G. Ngoerah from 2018 to 2019, there were more males than females and the highest distribution of CSOM was in the age range of 41-50 years. Conductive deafness is the highest type of hearing loss and judging from the degree of deafness, most people with CSOM have moderate to severe deafness.

Latar Belakang:  Otitis media supuratif kronis (OMSK) merupakan salah satu penyebab gangguan telinga di berbagai negara, terutama negara berkembang. Prevalensi OMSK di Indonesia adalah 3,8% atau diperkirakan sekitar 6,6 juta penduduk Indonesia. Tujuan dari penelitian ini adalah untuk mengetahui karakteristik audiometri pada penderita OMSK di Poliklinik THT-KL RSUP Prof. Dr. I.G.N.G. Ngoerah periode 2018-2019.

Metode: Penelitian ini menggunakan rancangan penelitian deskriptif retrospektif. Pengambilan sampel dilakukan secara total sampling yaitu setiap penderita yang memenuhi kriteria inklusi penelitian dimasukkan dalam sampel penelitian. Jumlah sampel yang dipergunakan adalah semua data deskriptif yang terkumpul pada skala periode yang telah ditentukan pada rancangan penelitian dimana pada penelitian didapatkan 70 sampel penelitian.

Hasil: Penderita OMSK perempuan sebanyak 33 orang (47,14%) dan penderita OMSK laki-laki sebanyak 37 orang (52,86%). Terdapat 4 orang (5,71%) OMSK berusia ≤ 10 tahun, 10 (14,29%) berusia 11-20 tahun, 8 (11,43%) berusia 21-30 tahun, 9 (12,86%) berusia 31-40 tahun, 19 (27,14%) berusia 41-50 tahun, 11 (15,71%) berusia 51-60 tahun, 5 (7,14%) berusia 61-70 tahun, 4 (5,71%) berusia lebih dari 70 tahun. Lebih lanjut, 42 pasien (60%) dengan OMSK mengalami gangguan pendengaran konduktif. 12,86% pasien mengalami gangguan pendengaran sensorineural, OMSK dengan tuli ringan sebanyak 13 orang (22,86%), tuli sedang 13 orang (34,29%), tuli sedang-berat 24 orang (28,57%), tuli berat 20 orang, tuli berat (28,6%), tuli sangat berat 8 orang (11,46%).

Simpulan: Proporsi penderita OMSK di poliklinik THT KL RSUP Prof. Dr. I.G.N.G. Ngoerah dari tahun 2018 sampai dengan tahun 2019, laki-laki lebih besar dari pada penderita perempuan dan distribusi OMSK tertinggi pada rentang usia 41-50 tahun. Tuli konduktif merupakan tipe gangguan pendengaran yang paling tinggi dan dilihat dari derajat ketuliannya, penderita OMSK sebagian besar memiliki derajat ketulian sedang-berat.

Background: Health workers are at high risk of developing depression, anxiety, and sleep disturbances due to increased stress during the COVID-19 pandemic; that matter is closely related to fatigue. The impact of psychosomatic disorders will have an immediate or indirect impact on the quality of health care services. This study aims to evaluate the psychosomatic disorder screening in health officers during the COVID-19 pandemic

Methods: A cross-sectional study was conducted in Esensia Clinic Semarang in February 2022. This study surveyed clinic health workers with completed questionnaires and had their Heart-Rate Variability (HRV) measurement. Data were analyzed using SPSS version 20 for Windows.

Results: About 138 subjects were recruited from Esensia Clinic, 100 subjects underwent this study until analysis. The unanxious subjects have the highest percentage accounting for 61.0%, followed by 25.0% mild anxiety, 12.0% moderate, and 2.0% severe. Furthermore, 86.0% were undepressed, followed by 13% mild and 1% moderate, but there was no severe case. Also, 65.0% did not experience fatigue and the percentage of good sleep quality (8.0%) is significantly lower than the poor (92.0%). The results also showed that 76.0% of the subjects had a balanced autonomic nervous system compared to the 24.0% of subjects with an autonomic imbalance.

Conclusion: The outcomes of psychosomatic disorders such as anxiety, depression, fatigue, and autonomic imbalance are generally poor. However, this study's prevalence of poor sleep quality was very high.

Introduction: Andropause is a collection of clinical symptoms due to a decrease in testosterone levels below normal limits. Androgenic alopecia is baldness caused by the susceptibility of the follicles to androgen hormones. The aims of study is determining the relationship between androgenic alopecia and andropause in civil servants at the Badung Regency Government Center.

Methods: The study design is cross-sectional with descriptive analytic. ADAM questionnaire is used to assessed andropause. Meanwhile, Norwood-Hamilton baldness scale is used to assessed androgenic alopecia.

Results:  Respondents in this study amounted to 40 people. A total of 27 (67.5%) positive andropause respondents and 13 respondents (33.5%) negative andropause. Meanwhile, 21 respondents (52.1%) were positive for androgenic alopecia and 19 respondents (47.5%) were negative for androgenic alopecia. There was a significant relationship (p<0.001) between andropause and androgenic alopecia. The odd ratio value (OR 95%CI) between andropause and androgenic alopecia is 34.3 (3.726-313.837).

Conclusion: Andropause has a significant relationship to androgenic alopecia of civil servants at the Badung Regency Government Center.

Pendahuluan: Andropause adalah kumpulan gejala klinis akibat kadar testosteron yang menurun di bawah batas normal. Alopesia androgenik adalah kebotakan yang disebabkan kerentanan folikel terhadap hormon androgen. Tujuan penelitian adalah menganalisis hubungan andropause dengan alopesia androgenik pada aparatur sipil negara di Pusat Pemerintahan Kabupaten Badung.

Metode: Rancangan penelitian adalah cross-sectional dengan deskriptif analitik. Kuesioner ADAM digunakan untuk menilai andropause dinilai. Sedangkan, alopesia androgenik dinilai dengan menggunakan skala kebotakan Norwood-Hamilton.

Hasil: Responden dalam penelitian ini berjumlah 40 orang. Sebanyak 27 (67,5%) responden positif andropause dan 13 responden (33,5%) negatif andropause. Sementara itu, 21 responden (52,1%) positif alopesia androgenik dan 19 responden (47,5%) negatif alopesia androgenik. Terdapat hubungan yang signifikan (p<0,001) antara andropause dan alopesia androgenik. Adapun nilai odd ratio (OR 95%CI) antara andropause dan alopesia androgenik adalah 34,3 (3,726-313,837).

Simpulan: Andropause memiliki hubungan signifikan terhadap alopesia androgenik pada aparatur sipil negara di Pusat Pemerintahan Kabupaten Badung.

Introduction: The prevalence of musculoskeletal trauma in Indonesia is increasing. Complications that occur due to mishandling are often found in health facilities. The development of medical health facilities has not made people switch from traditional medicine as an alternative treatment for musculoskeletal trauma that has been passed down for generations. Education and attitude can be factors in considering risks in choosing the right treatment. The purpose of this study was to determine the relationship between education level and attitude towards musculoskeletal trauma treatment options.

Method: This research method is an observational analytic with a cross-sectional design. The research subjects were residents of Banda Aceh City was as many as 200 respondents who were carried out in eleven public health centers representing nine sub-districts in Banda Aceh City.

Result: The results of this study indicate that 108 (54.0%) respondents chose traditional medicine while 92 (46.0%) other respondents chose medical treatment as a solution for treating musculoskeletal trauma. Respondents with secondary education chose traditional medicine by 62.7%, while respondents with higher education chose traditional medicine by 42.9%. Respondents with a sufficient attitude chose traditional medicine by 95.6%, while respondents with a good attitude chose traditional medicine by 31.4%. Based on the results of the Spearman rho test, it showed that there was a relationship between educational level (p=0.039) and attitude (p=0.000) towards the choice of musculoskeletal trauma treatment.

Conclusion: Various promotive efforts and health education, especially musculoskeletal trauma, need to be continuously carried out by both health workers and policy makers to improve people's attitudes in choosing the right treatment and reducing the number of complications due to mishandling of musculoskeletal trauma in Banda Aceh City.

Pendahuluan: Prevalensi trauma muskuloskeletal di Indonesia semakin meningkat. Komplikasi yang terjadi akibat kesalahan penanganan banyak ditemukan di fasilitas kesehatan.  Berkembangnya fasilitas kesehatan medis tidak membuat masyarakat beralih dari pengobatan tradisional sebagai alternatif pengobatan trauma muskuloskeletal yang sudah turun temurun. Pendidikan dan sikap dapat menjadi faktor dalam mempertimbangkan risiko dalam memilih pengobatan yang tepat. Tujuan dari penelitian ini adalah untuk mengetahui hubungan tingkat pendidikan dan sikap terhadap pilihan pengobatan trauma muskuloskeletal.

Metode: Metode penelitian ini berupa analitik observasional dengan desain cross-sectional. Subjek penelitian adalah penduduk Kota Banda Aceh sebanyak 200 responden yang dilaksanakan pada sebelas puskesmas yang mewakili sembilan kecamatan di Kota Banda Aceh.

Hasil: Hasil penelitian ini menunjukkan bahwa 108 (54,0%) responden memilih pengobatan tradisional sedangkan 92 (46,0%) responden lainnya memilih pengobatan medis sebagai solusi untuk penanganan trauma muskuloskeletal. Responden dengan pendidikan menengah memilih pengobatan tradisional sebesar 62,7%, sedangkan responden dengan pendidikan tinggi memilih pengobatan tradisional sebesar 42,9%. Responden dengan sikap yang cukup memilih pengobatan tradisional sebesar 95,6%, sedangkan responden dengan sikap yang baik memilih pengobatan tradisional sebesar 31,4%. Berdasarkan hasil uji Spearmann rho menunjukkan bahwa terdapat hubungan antara tingkat pendidikan (p=0,039) dan sikap (p=0,000) terhadap pilihan pengobatan trauma muskuloskeletal.

Simpulan: Berbagai upaya promotif dan penyuluhan kesehatan khususnya trauma muskuloskeletal perlu terus dilakukan baik dari tenaga kesehatan maupun pemegang kebijakan untuk meningkatkan sikap masyarakat dalam memilih pengobatan yang tepat serta menekan angka komplikasi akibat kesalahan penanganan trauma muskuloskeletal di Kota Banda Aceh.

Introduction: Dysmenorrhea is pain that is quite severe during menstruation which interferes with daily activities and habits. Women who suffer from dysmenorrhea are about 50% of the world's population. Prostaglandin levels that are out of balance in primary dysmenorrhea lead to pain through increased uterine contractility, decreased uterine blood flow, and increased sensitivity of peripheral nerves. Coffee drinking is one of the risk factors for primary dysmenorrhea. This study aims to determine the association between coffee consumption and primary dysmenorrhea of female students of bachelor of medicine programs batch 2021, Faculty Of Medicine, Universitas Udayana.

Methods: This is an analytic study with a cross-sectional approach. The research sample was selected randomly by purposive random sampling technique. The data obtained were then processed and analyzed using Microsoft Excel and SPSS.

Results: The study was conducted on 95 female students of bachelor of medicine programs batch 2021, Faculty Of Medicine, Universitas Udayana. Based on analysis tests, it was found that there was a significant association between coffee consumption and the incidence of primary dysmenorrhea (p = 0,003). The results of the odds ratio (OR) test were 4.03, thus female students who consumed coffee may have a risk of primary dysmenorrhea of 4.03 times.

Conclusion: There is a significant association between coffee consumption and the incidence of primary dysmenorrhea in female students bachelor of medicine programs batch 2021, Faculty Of Medicine, Udayana University.

Pendahuluan: Dismenore adalah rasa nyeri cukup parah pada masa menstruasi yang mengganggu aktivitas dan kebiasaan sehari-hari. Wanita yang menderita dismenore yaitu sekitar 50% dari populasi dunia. Dismenore primer disebabkan oleh ketidakseimbangan level prostaglandin yang menciptakan rasa sakit karena meningkatnya kontraktilitas uterus, penurunan aliran darah uterus, dan peningkatan sensitivitas saraf perifer. Konsumsi kopi merupakan salah satu faktor risiko dari dismenore primer. Penelitian ini memiliki tujuan untuk mengevaluasi hubungan antara konsumsi kopi dan dismenore primer pada mahasiswi Program Studi Sarjana Kedokteran Fakultas Kedokteran Universitas Udayana (PSSK FK UNUD) angkatan 2021.

Metode: Penelitian menggunakan studi analitik dengan desain cross-sectional. Teknik pengambilan sampel adalah purposive random sampling. Data yang diperoleh selanjutnya diolah dan dianalisis menggunakan perangkat lunak Microsoft Excel dan SPSS.

Hasil: Penelitian dilakukan pada 95 mahasiswi PSSK FK UNUD angkatan 2021. Berdasarkan uji analisis, didapatkan hubungan signifikan antara konsumsi kopi (p = 0,003). Hasil dari pengujian odds ratio (OR) didapat sebesar 4,03 sehingga mahasiswi yang mengonsumsi kopi memiliki risiko terjadinya dismenore primer sebesar 4,03 kali.

Simpulan: Terdapat terdapat hubungan yang bermakna antara konsumsi kopi dengan kejadian dismenore primer pada mahasiswi PSSK FK UNUD angkatan 2021.

Background: Ptosis or blepharoptosis is a condition where the eyelid droops below its normal position. Ptosis can affect the visual field by reducing the patient's visual acuity. Ptosis is also considered a problem in appearance because the patient will always look tired and sleepy. If not treated immediately, ptosis can cause further complications, such as refractive errors, strabismus, and amblyopia. The purpose of this study is to identify the demographic and clinical characteristics of ptosis patients at Prof. dr. I G.N.G. Ngoerah Hospital.

Methods: This descriptive study with a cross-sectional design and total sampling was carried out at Prof. dr. I G.N.G. Ngoerah Hospital with ptosis patient data in 2019-2021.

Results: There were 45 ptosis patients at Prof. dr. I G.N.G. Ngoerah Hospital in 2019-2021. In this study, the majority of ptosis patients were male. (53.3%). Patients in this study had a mean age of 37.91±23.55 years old with a median of 33(1-85). Unilateral ptosis (88.9%) and acquired ptosis (73.3%) were the most common ptosis cases found in this study. There are three etiologies that dominate ptosis cases, namely neurogenic (28.9%), traumatic (28.9%), and myogenic (26.7%) ptosis. Most of the ptosis patients have a severe degree of ptosis (60.0%). As many as 80% of ptosis patients receive surgical management.

Conclusion: Ptosis cases in Prof. dr. I G.N.G. Ngoerah Hospital in 2019-2021 were dominated by male patients, unilateral ptosis, acquired ptosis, neurogenic, and severe degree. Further research is required to evaluate the association between variables. with a larger population.

Latar Belakang: Ptosis atau blepharoptosis merupakan kondisi turunnya kelopak mata di bawah posisi normal. Ptosis dapat memengaruhi lapang pandang dengan mengurangi ketajaman visual pasien. Ptosis juga dianggap sebagai permasalahan dalam penampilan dikarenakan pasien akan selalu terlihat kelelahan dan mengantuk. Apabila tidak segera ditangani, ptosis dapat menyebabkan terjadinya komplikasi lebih lanjut, seperti kelainan refraksi, strabismus, dan ambliopia. Tujuan dari penelitian ini adalah untuk mengetahui karakteristik demografis dan klinis pasien ptosis di RSUP Prof. dr. I G.N.G. Ngoerah. 

Metode: Penelitian deskriptif dengan desain cross-sectional dan penentuan sampel secara total sampling ini dilaksanakan di RSUP Prof. dr. I G.N.G. Ngoerah dengan data pasien ptosis pada tahun 2019-2021.

Hasil: Pasien ptosis di RSUP Prof. dr. I G.N.G. Ngoerah pada tahun 2019-2021 berjumlah 45 orang. Sebagian besar pasien ptosis dalam penelitian ini berjenis kelamin laki-laki (53,3%). Pasien dalam penelitian ini memiliki rerata usia 37,91±23,55 tahun dengan median 33 (1-85). Ptosis unilateral (88,9%) dan acquired ptosis (73,3%) merupakan kasus ptosis yang mendominasi dalam penelitian ini. Terdapat tiga etiologi yang mendominasi kasus ptosis pada pasien, yaitu ptosis neurogenik (28,9%), traumatik (28,9%), dan miogenik (26,7%). Sebagian besar pasien ptosis memiliki derajat keparahan dalam kategori berat (60,0%). Sebanyak 80% dari pasien ptosis menerima tatalaksana operasi.

Simpulan: Kasus ptosis di RSUP Prof. dr. I G.N.G. Ngoerah pada tahun 2019-2021 didominasi oleh pasien laki-laki, ptosis unilateral, acquired ptosis, neurogenik, dan derajat berat. Penelitian lebih lanjut diperlukan untuk menilai hubungan antar variabel dengan populasi yang lebih besar.

Background: Coronary heart disease (CHD) is a complication of type 2 diabetes mellitus (DMT2). However, in the process of developing CHD in T2DM patients, other risk factors that contribute multifactorial are needed. This study aims to determine the prevalence of CHD events in T2DM patients as well as to determine the relationship between risk factors and CHD events in T2DM patients.

Methods: This study is an analytic cross-sectional study conducted at Prof. Dr. I.G.N.G. Ngoerah Hospital. The population target was all T2DM patients in the period January 2021-December 2021, in which 80 patient samples were obtained according to the inclusion and exclusion criteria and were taken through secondary data on patient medical records. Data processing was carried out using the SPSS ver. 28.0.1.1.

Results: The prevalence of CHD in T2DM patients was 25 people (31.3%). The risk factors for CHD in T2DM patients are hyperglycemia (HbA1c ≥6.5%) (p=0.036, 95% CI=1.166-85.788, aOR=10.567), blood pressure ≥140/90 mmHg p=0.008, 95%CI=11.541-17.017, aOR=5.121), and obesity (p=0.014, 95%CI=1.364-16.420, aOR=4.732) while male sex (p=0.428), age ≥50 years (p=0.543), smoking (p=0.937), family history of cardiovascular disease (p=0.663), LDL ≥160 mg/dL (p=0.946), triglyceride ≥200 mg/dL (p=0.192, 95%CI=0.680-6.847, aOR=2.158), HDL <40 mg/dL (p=0.487), and total cholesterol level ≥240 mg/dL (p=0.866) are not significantly associated with CHD events in patients DMT2.

Conclusion: The prevalence of CHD in T2DM patients is 31.1% at Prof. Dr. I.G.N.G. Ngoerah Hospital in 2021. Risk factors such as hyperglycemia, blood pressure ≥140/90 mmHg, and obesity are significantly associated with the incidence of CHD in T2DM patients.

Latar belakang: Penyakit jantung koroner (PJK) merupakan salah satu komplikasi diabetes melitus tipe 2 (DMT2). Namun, dalam proses perkembangan PJK pada pasien DMT2, diperlukan faktor risiko lainnya yang berkontribusi secara multifactorial. Secara teoritis, jenis kelamin laki-laki, usia, riwayat merokok, riwayat penyakit kardiovaskuler keluarga, hiperglisemia, dislipidemia, tekanan darah ≥140/90mmHg, dan obesitas merupakan faktor risiko PJK pada DMT2. Penelitian ini bertujuan untuk mengetahui prevalensi kejadian PJK pada pasien DMT2 sekaligus untuk mengetahui hubungan faktor risiko dengan kejadian PJK pada pasien DMT2.

Metode: Penelitian ini merupakan penelitian cross-sectional analitik yang dilakukan pada RSUP Prof. Dr. I.G.N.G. Ngoerah dengan target penelitian adalah seluruh pasien DMT2 pada periode Januari 2021-Desember 2021. Pada penelitian ini, 80 sampel pasien yang sesuai dengan kriteria inklusi dan eksklusi diambil melalui data sekunder rekam medis pasien. Pengolahan data dilakukan menggunakan aplikasi SPSS ver. 28.0.1.1.

Hasil: Prevalensi PJK pada pasien DMT2 adalah sebanyak 25 orang (31.3%). Adapun faktor risiko PJK pada pasien DMT2 adalah Hiperglisemia (HbA1c ≥6.5%) (p=0.036, 95%CI=1.166-85,788, aOR=10.567), tekanan darah ≥140/90 mmHg p=0.008, 95%CI=11.541-17.017, aOR=5.121), dan obesitas (p=0.014, 95%CI=1.364-16.420, aOR=4.732) sedangkan jenis kelamin laki-laki (p=0.428), usia ≥50 tahun (p=0.543), riwayat merokok (p=0.937), riwayat penyakit kardiovaskuler keluarga (p=0.663), kadar LDL ≥160 mg/dL (p=0.946), kadar trigliserida ≥200 mg/dL(p=0.192, CI=0.680-6.847, aOR=2.158), kadar HDL <40 mg/dL (p=0.487), kadar total kolesterol ≥240 mg/dL (p=0.866) tidak berhubungan secara signifikan dengan kejadian PJK pada pasien DMT2.

Simpulan: Prevalensi PJK pada pasien DMT2 sebesar 31.1%. Faktor risiko berupa hiperglisemia, tekanan darah ≥140/90 mmHg, dan obesitas berhubungan signifikan dengan kejadian PJK pada pasien DMT2.

Background: The rapid development of technology accompanied by a shift in sports interest towards eSports or online games in adolescents causes them to spend longer in front of the screen. Poor application of ergofthalmology can trigger Computer Vision Syndrome (CVS), while bad gaming habits can cause Internet Gaming Disorder (IGD).

Purpose: The purpose of this study is to know the characteristics of CVS with IGD in high school students.

Method: A descriptive study using a cross-sectional method with total sampling. Samples were taken from one of the high schools in Tabanan Regency. There were 362 samples that met the inclusion criteria. CVS diagnosis based on the CVS-Q questionnaire and the IGD with the IGDS-9-SF questionnaire in Indonesian. The features are based on gender, screentime and daily leisure time routine.

Results: The mean age of the respondents was 16.64 years ± 0.692. The overall CVS prevalence was 59.9% (n=217). The distribution of CVS symptoms included itchy eyes (53.3%; n=193), headaches (50.5%; n=183) and the sensation of burning and watery eyes (50.3%; n=182). The prevalence of ED was 0.8% (n=3); CVS without IGD 59.4% (n=215); while CVS with IGD was 0.6% (n=2). There are characteristics in screentime of more than 4 hours and daily routine of watching dramas/movies, while differences are found based on gender. Based on gender, CVS without IGD was more common in women (37.6%;n=136), while CVS accompanied by IGD had the same prevalence in both men and women of 0.3% (n=1)

Conclusion: There are similarities between CVS without IGD and CVS accompanied by IGD based on screen time and daily routines. Different characteristics found by sex.

Latar Belakang: Perkembangan teknologi yang semakin pesat diiringi pergeseran minat olahraga menuju eSports atau game online pada remaja menyebabkan mereka lebih lama melakukan aktivitas di depan layar. Penerapan ergoftalmologi yang buruk dapat memicu Computer Vision Syndrome (CVS), sedangkan kebiasaan bermain game yang buruk dapat menimbulkan Internet Gaming Disorder (IGD). Penelitian ini bertujuan untuk mengetahui karakteristik CVS pada siswa SMA dengan IGD

Metode: Studi deskriptif menggunakan metode potong lintang dengan total sampling. Sampel yang diambil dari salah satu SMA di Kabupaten Tabanan. Terdapat 362 sampel yang memenuhi kriteria inklusi. Diagnosis CVS berdasarkan kuisioner CVS-Q serta IGD dengan kuesioner IGDS-9-SF dalam bahasa Indonesia. Karakteristik dibandingkan berdasarkan jenis kelamin, screentime dan rutinitas harian saat senggang.

Hasil: Rerata usia responden 16,64 tahun ±0,692. Prevalensi CVS secara keseluruhan 59.9% (n=217). Distribusi gejala CVS diantaranya mata gatal (53,3%; n=193), sakit kepala (50,5%; n=183) dan sensasi mata perih serta berair (50,3%; n=182). Prevalensi IGD sebesar 0,8% (n=3); CVS tanpa disertai IGD 59,4% (n=215); sedangkan CVS disertai IGD 0,6% (n=2). Terdapat kesamaan karakteristik pada screentime lebih dari 4 jam dan rutinitas harian menonton drama/film, sedangkan perbedaan ditemukan berdasarkan jenis kelamin. Berdasarkan jenis kelamin,  CVS tanpa disertai IGD lebih banyak terjadi pada perempuan (37,6%;n=136), sedangkan CVS disertai IGD memiliki prevalensi yang sama baik pada laki-laki dan perempuan sebesar 0,3% (n=1)

Kesimpulan: Karakteristik antara CVS tanpa disertai IGD dengan CVS disertai IGD terdapat kesamaan berdasarkan screentime dan rutinitas harian. Perbedaan karakteristik ditemukan berdasarkan jenis kelamin.

Background: Physical fitness is one aspect that needs to be fulfilled by humans in order to be able to carry out activities without feeling significant fatigue. Short-term memory is a memory storage system with limited capabilities. The educational process requires good memory skills so that a person can receive information that can then be processed according to the individual's needs. Increased physical fitness caused by aerobic exercise has been reported to be able to increase brain perfusion and plasticity in the hippocampal area which then improves memory abilities. This study aims to determine the relationship between physical fitness and short-term memory abilities.

Method: This analytic observational study used a cross-sectional design to evaluate the relationship between the test variables. The research sample was students of the Bachelor of Medicine Study Program, Faculty of Medicine, Udayana University for the academic year 2022/2023 who met the research criteria, and the method of taking was using simple random sampling. Physical fitness is measured by the physical fitness index. Short-term memory ability was assessed by the Modified Harvard Step Test and Digit span test. Data analysis was performed with SPSS v. 20.

Results: A total of 100 students were obtained as research subjects. Most of the subjects had a very good physical fitness index, 33 students (33%) and good short-term memory skills, 37 students (37%). The results of the bivariate analysis showed a significant relationship between the two variables in students of the Medical Faculty Study Program, Faculty of Medicine, Udayana University with a chi-square value (p = 0.02) and a Spearman rank value (p = 0.018).

Conclusion: There was a significant relationship between physical fitness and the short-term memory of the student.

Latar Belakang: Kebugaran jasmani merupakan aspek yang berkaitan dengan kesehatan fisik manusia. Memori jangka pendek merupakan sistem penyimpanan memori dengan kapasitas yang terbatas. Adapun proses pendidikan membutuhkan kemampuan memori yang baik. Meningkatnya kebugaran jasmani yang disebabkan oleh olahraga aerob telah dilaporkan mampu meningkatkan perfusi dan plastisitas otak pada daerah hipokampus yang dapat meningkatkan kemampuan memori. Penelitian ini bertujuan mengetahui hubungan kebugaran jasmani terhadap kemampuan memori jangka pendek pada mahasiswa.

Metode: Penelitian ini merupakan studi observasional analitik dengan desain cross sectional untuk melihat hubungan antara variabel uji. Sampel penelitian adalah mahasiswa Program Studi Sarjana Kedokteran Fakultas Kedokteran Universitas Udayana tahun ajaran 2022/2023 yang memenuhi kriteria penelitian, dengan cara pengambilan menggunakan simple random sampling. Kebugaran jasmani diukur dengan indeks kebugaran jasmani berdasarkan Modified Harvard Step Test. Kemampuan memori jangka pendek dinilai dengan dan Digit span test. Analisis data dilakukan dengan SPSS v.20.

Hasil: Sebanyak 100 mahasiswa diperoleh sebagai subjek penelitian. Sebagian besar subjek memiliki indeks kebugaran jasmani yang sangat baik, yakni sebanyak 33 orang (33%) dan kemampuan memori jangka pendek yang baik, sebanyak 37 orang (37%). Analisis bivariat menunjukkan hubungan yang signifikan antara kedua variabel pada mahasiswa Program Studi Sarjana Kedokteran Fakultas Kedokteran Universitas Udayana berdasarkan uji chi-square (p = 0,02) dan rank spearman (p=0,018).

Simpulan: Terdapat hubungan signifikan antara kebugaran jasmani dengan kemampuan memori jangka pendek pada mahasiswa.

Latar Belakang         : DM merupakan penyakit yang umum terjadi yakni sebesar 425 juta orang dengan angka mortalitas sebesar 1,5 juta orang. Komplikasi kronis dari DM tipe 2 dapat berupa komplikasi mikrovaskular dan makrovaskular. DM tipe 2 yang tidak terkontrol akan menyebabkan terjadinya hipertensi.  Hal ini dapat dicegah sedini mungkin dengan menilai pemeriksaan rutin kadar glukosa darah dan tekanan darah, namun masih sedikit dokumentasi penelitian mengenai hubungan kadar glukosa pada pasien DM dengan kejadian hipertensi. Oleh karenanya, peneliti tertarik melakukan penelitian untuk mengetahui hubungan glukosa darah puasa dengan hipertensi pada pasien DM tipe 2 yang dirawat jalan di RSUD Kabupaten Lombok Utara

Metode Penelitian     : Penelitian ini merupakan penelitian analitik observasional dengan desain penelitian cross sectional menggunakan metode purposive sampling pada data Rekam Medis pasien DM yang memenuhi kriteria inklusi yakni pasien yang terdiagnosis menderita DM tipe 2 oleh dokter apabila GDP ≥ 126 mg/dl dan pasien yang berusia 18 tahun dan ekslusi yakni pasien DM dengan keadaan tertentu (HIV, CKD, Keganasan) serta pasien yang menjalani kemoterapi di RSUD Kabupaten Lombok Utara

Hasil Penelitian         : Total terdapat 329 responden yang termasuk dalam penelitian ini dengan rerata usia adalah 50-60 tahun dan mayoritas jenis kelamin perempuan (66%). Ditemukan dari seluruh responden dengan kontrol glikemik yang terkontrol sebesar 13,4% dan kejadian hipertensi terjadi sebanyak 35,9%. Berdasarkan hasil uji Chi-square diperoleh bahwa Hasil analisis bivariat menunjukkan bahwa nilai p-value < 0,05 (p-value = 0,006).

Kesimpulan                : Berdasarkan hasil penelitian ini, dapat disimpulkan bahwa terdapat hubungan yang signifikan antara kadar glukosa darah puasa dengan hipertensi pada pasien diabetes melitus tipe 2 di RSUD Kabupaten Lombok Utara.

Background: During pregnancy there’s an increase of fluid which may cause problems in the cardiovascular system that were previously undiagnosed. Approximately 1–4% of pregnancies globally cause complications of cardiovascular disease. This study aims to determine the characteristics of pregnant patients with heart disease who were inpatients at Dr. Kariadi Hospital in the year 2020-2021.

Methods: This study used a descriptive research design conducted at Dr. Kariadi Hospital with secondary data through medical records for the year period of 1 January 2020 – 31 December  2021. A sample of 157 was all cases of pregnancy with heart disease treated in the obstetrics room or intensive care unit (ICU).

Result: Heart disease most suffered by pregnant patients was hypertensive heart disease as many as 90 cases (57.65%), peripartum cardiomyopathy 18 cases (11.54%). From echocardiography, 17 cases (16.34%) had decreased left ventricular ejection fraction and 14 cases (11.02%) had decreased right ventricular systolic function. 25 cases (19.54%) had impaired cardiac muscle kinesity and 57 cases (50.43%) had diastolic dysfunction. Most valve disorders occurred in the mitral, those were 22 cases (17.33%). Only 5 cases (3.2%) of these patients had COVID-19. Based on vital signs and laboratory examinations, data were obtained for 35 cases (22.29%) patients had a pulse of more than 100x/minute upon arrival at Dr. Kariadi Hospital only 2 cases (1.27%) had a pulse below 60x/minute. On saturation examination, 13 cases (8.26%) patients experienced desaturation.

Conclusion: Hypertensive heart disease has the highest prevalence. Premature birth and the incidence of low birth weight is the highest incidence in pregnant patients with heart disease.

Latar belakang: Selama kehamilan terjadi peningkatan cairan yang dapat menyebabkan masalah pada sistem kardiovaskular yang sebelumnya tidak terdiagnosis. Sekitar 1-4% kehamilan secara global menyebabkan komplikasi penyakit kardiovaskular. Penelitian ini bertujuan untuk mengetahui karakteristik pasien hamil dengan penyakit jantung yang dirawat inap di RSUP Dr. Kariadi periode tahun 2020-2021.

Metode: Studi ini menggunakan desain penelitian deskriptif yang dilakukan di RSUP Dr. Kariadi dengan data sekunder melalui rekam medis periode 1 Januari 2020 - 31 Desember 2021. Sampel sebanyak 157 adalah semua kasus kehamilan dengan penyakit jantung yang dirawat di ruang obstetri maupun intensive care unit (ICU).

Hasil: Penyakit jantung yang paling banyak diderita oleh pasien hamil adalah penyakit jantung hipertensi sebanyak 90 kasus (57,65%), kardiomiopati peripartum 18 kasus (11,54%). Dari ekokardiografi, 17 kasus (16,34%) mengalami penurunan fraksi ejeksi ventrikel kiri dan 14 kasus (11,02%) mengalami penurunan fungsi sistolik ventrikel kanan. 25 kasus (19,54%) mengalami gangguan kinesitas otot jantung dan 57 kasus (50,43%) mengalami disfungsi diastolik. Kelainan katup paling banyak terjadi pada mitral yaitu 22 kasus (17,33%). Hanya 5 kasus (3,2%) dari pasien ini yang memiliki COVID-19. Berdasarkan tanda vital dan pemeriksaan laboratorium didapatkan data sebesar 35 kasus (22,29%) pasien memiliki denyut nadi lebih dari 100x/menit saat tiba di RSUP Dr. Kariadi, hanya 2 kasus (1,27%) yang memiliki denyut nadi dibawah 60x/menit. Pada pemeriksaan saturasi sebesar 13 kasus (8,26%) pasien mengalami desaturasi.

Simpulan: Penyakit jantung hipertensi memiliki prevalensi tertinggi. Kelahiran prematur dan kejadian berat badan lahir rendah merupakan kejadian tertinggi pada pasien hamil dengan penyakit jantung.

Background: Presbycusis or age-related hearing loss, is the most common cause of hearing loss and also the most common neurodegenerative disorder. This age-related hearing loss occurs in the population over 60 years of age. This study aims to determine the type of presbycusis in presbycusis patients at the ENT Polyclinic of Prof. Dr. I.G.N.G. Ngoerah Hospital for the period of January-December 2020.

Methods: This study is a retrospective descriptive study with a total sample of 42 people taken consecutively in presbycusis patients at the ENT Polyclinic of Prof. Dr. I.G.N.G. Ngoerah Hospital for the period of January-December 2020.

Results: The results showed that the audiogram results based on the right and left ears, 42.8% and 45.2% had strial type presbycusis, 30.9% and 28.6% had cochlear type presbycusis, 21.4% and 23.8% had sensory type presbycusis, 4.8% and 2.4% had neural type presbycusis.

Conclusion: From the results of this study, it can be concluded that the average degree of deafness of the right and left ears is moderate-heavy, with the dominant type of presbycusis being the strial or metabolic type. Presbycusis shows a wide variation in the degree of deafness, hearing acuity, age of onset, and progression, so it is likely that the burden of presbycusis in the population may increase in the future.

Latar Belakang: Presbikusis atau penurunan pendengaran terkait usia, merupakan penyebab gangguan pendengaran dan sekaligus juga merupakan gangguan neurodegeneratif yang paling sering terjadi. Penurunan pendengaran terkait usia ini terjadi pada populasi usia lebih dari 60 tahun. Penelitian ini bertujuan untuk mengetahui jenis presbikusis pada pasien presbikusis di Poliklinik THT-KL RSUP Prof. Dr. I.G.N.G. Ngoerah periode Januari-Desember 2020.

Metode: Penelitian ini adalah penelitian deskriptif retrospektif dengan total sampel sebanyak 42 orang yang diambil secara konsekutif pada pasien presbikusis di Poliklinik THT-KL RSUP Prof. Dr. I.G.N.G. Ngoerah periode Januari-Desember 2020.

Hasil: Hasil penelitian menunjukkan bahwa hasil audiogram berdasarkan telinga kanan dan kiri, sebanyak 42,8% dan 45,2% mengalami presbikusis tipe strial, 30,9% dan 28,6% mengalami presbikusis tipe koklea, 21,4% dan 23,8% mengalami presbikusis tipe sensori, sebanyak 4,8% dan 2,4% mengalami presbikusis tipe neural.

Simpulan: Dari hasil penelitian ini dapat disimpulkan bahwa derajat ketulian telinga kanan dan kiri rata-rata adalah derajat sedang-berat, dengan tipe presbikusis yang dominan adalah tipe strial atau metabolik. Presbikusis memperlihatkan variasi yang beragam pada derajat ketulian, ketajaman pendengaran, onset umur, dan progresinya sehingga kemungkinan beban presbikusis di populasi dapat meningkat di kemudian hari.

Background: A bilirubin level in the blood higher than normal is called hyperbilirubinemia. Hyperbilirubinemia's prevalence is 60% in term newborns and 80% in preterm newborns. Low birth weight is a risk factor for hyperbilirubinemia. Phototherapy for low birth weight with hyperbilirubinemia is given for a longer time and has a higher rebound effect. This study aims to compare phototherapy effectiveness in treating hyperbilirubinemia between normal birth weight and low birth weight.

Methods: Analytical study using medical records at Wangaya Hospital during January 2020-January 2022. Inclusion criteria include hyperbilirubinemia required phototherapy, bilirubin level before and after phototherapy checked, and single light phototherapy. Exclusion criteria include conjugated hyperbilirubinemia, exchange transfusion, sepsis, severe congenital malformation, patients in NICU and incomplete medical record.

Results: From 99 study subjects, 19% had low birth weight, and 81% had normal birth weight. The mean bilirubin serum before phototherapy was 15.52mg/dL for LBW and 15.27mg/dL for NBW. The mean bilirubin serum after phototherapy was 5.77mg/dL for LBW and 7.46mg/dL for NBW. The mean bilirubin difference was 9.75mg/dL for LBW and 7.81mg/dL for NBW. The mean phototherapy duration was 52 hours for LBW and 47.6 hours for NBW. Decreasing rate of bilirubin was 0.19mg/dL/hour for LBW and 0.18mg/dL/hour for NBW. Independent t-test showed a p-value of 0.571, meaning no significant difference was found in phototherapy effectiveness in treating hyperbilirubinemia between normal birth weight and low birth.

Conclusion: No significant difference was found in phototherapy effectiveness in treating hyperbilirubinemia between NBW and LBW. But, phototherapy in LBW was started earlier, required more time and has a lower bilirubin level target than NBW.

Latar Belakang: Bilirubin darah melebihi normal disebut hiperbilirubinemia. Prevalensi hiperbilirubinemia berkisar antara 60% pada bayi cukup bulan dan 80% pada bayi prematur. Bayi berat lahir rendah merupakan risiko hiperbilirubinemia. Fototerapi bayi berat lahir rendah diberikan lebih lama daripada bayi berat lahir normal dan memiliki efek rebound lebih tinggi. Tujuan penelitian adalah mengetahui komparasi efektifitas fototerapi dalam kasus hiperbilirubinemia pada kelompok bayi berat lahir normal dan rendah.

Metode: Penelitian analitik menggunakan rekam medis di RSUD Wangaya Kota Denpasar periode Januari 2020-Januari 2022. Kriteria inklusi pada penelitian ini adalah pasien hyperbilirubinemia yang memerlukan fototerapi, kadar bilirubin sebelum dan sesudah fototerapi, dan fototerapi single-light. Kriteria eksklusi meliputi hiperbilirubinemia terkonjugasi, transfusi tukar, sepsis, kelainan kongenital berat, pasien perawatan di NICU, serta rekam medis tidak lengkap.

Hasil: Dari 99 subyek penelitian, 19% BBLR dan 81% BBLN. Rerata bilirubin pre-fototerapi 15,52 mg/dL pada BBLR dan 15,27 mg/dL pada BBLN. Rerata bilirubin post fototerapi 5,77mg/dL pada BBLR dan 7.46 mg/dL pada BBLN. Rerata selisih bilirubin fototerapi 9,75 mg/dL pada BBLR dan 7,81 mg/dL pada BBLN. Rerata waktu fototerapi 52 jam pada BBLR dan 47,6 jam pada BBLN.  Laju turun bilirubin 0,19 mg/dL/jam pada BBLR dan 0,18 mg/dL/jam pada BBLN. Uji t-test tidak berpasangan menunjukkan p-value > 0,05 yaitu 0,571 menandakan tidak ada perbedaan efektifitas fototerapi dalam kasus hiperbilirubinemia pada kelompok bayi berat lahir normal dan rendah.

Kesimpulan: Tidak ada perbedaan efektifitas fototerapi dalam kasus hiperbilirubinemia pada kelompok bayi berat lahir normal dan rendah. Namun, didapatkan bahwa fototerapi dimulai pada usia yang lebih awal, dengan waktu fototerapi yang lebih lama dan target bilirubin pasca fototerapi yang lebih rendah pada kelompok BBLR dibandingkan BBLN.

Introduction: Cervical cancer is the second most common cancer in women worldwide. The highest cancer incidence in women in Indonesia is cervical cancer, with a total of 17 cases per 100,000 female population. Human papillomavirus (HPV) is the main cause of cervical cancer. Acceptance of this vaccine is related to the level of knowledge about the virus and the vaccine itself. Previous systematic studies revealed that most women do not have a sufficient level of knowledge about the relationship between HPV virus infection and cervical cancer. This study aims to know the level of knowledge about cervical cancer and HPV vaccination in an adolescent girl

Methods: This research was conducted with a cross-sectional design. This study uses primary data in the form of answers to questionnaires distributed to respondents, where the questionnaire has been tested for validity and reliability in previous studies. The subjects were girl students aged 14 to 18 years at the senior high school level in the city of Denpasar.

Results: Most of the research subjects (95,3%)  had fairly good-sufficient knowledge about cervical cancer, with a median value of 8 (4-10) of the assessment result. However, the majority of the research subjects (50,4%) had a low level of knowledge about HPV vaccination, with a median value of 11 (0-22) of the assessment result.

Conclusion: This study shows that the majority of students in senior high school have good knowledge about cervical cancer but a lack of knowledge about HPV vaccination.

Introduction: Hirsprung's case surgery method is usually done through 3 stages. Since the three-step method greatly influences the incidence of postoperative enterocolitis and malnutrition, a single-stage surgery technique was developed. This technique is safe, cost-effective, and avoid stoma-related morbidity in infants. This study aimed to determine the difference in the clinical outcome between Swenson-like transanal and Soave 1 stage transanal procedures in patients with hirschsprung's disease.

Methods: This was a retrospective cohort study by taking secondary data from patient medical records from years 2017 to 2021. The total sample of 100 Hirschprung patients was divided into two groups; patients with transanal Swenson-like surgical techniques and Soave. Data were tabulated and statistically analyzed with descriptive and association analysis.

Results: There were differences in operating time based on the surgical technique used, with a median of 120.00 minutes in the 1st stage Swenson-like transanal technique group and 150.17 minutes in the transanal Soave group. The length of stay of patients with the Swenson-like surgical technique was shorter than the Soave technique (p <0.001). Postoperative complications of enterocolitis were less common with the Swenson-like technique than with the Soave technique.

Conclusion: There are differences in clinical outcomes in postoperative Hirschsprung patients with the Swenson-like and Soave 1 stage transanal technique..

Pendahuluan: Metode pembedahan kasus hirschsprung pada umumnya dilakukan melalui 3 tahap. Namun metode tiga tahap sangat berpengaruh terhadap kejadian enterokolitis dan malnutrisi paska pembedahan, sehingga dikembangkan pembedahan dengan teknik 1 tahap yang diketahui aman, cost-effective, dan menghindari morbiditas akibat stoma pada bayi. Penelitian ini bertujuan untuk mengetahui perbedaan luara klinis antara tindakan transanal Swenson-like dan transanal Soave 1 tahap pada pasien dengan penyakit Hirschsprung.

Metode: Penelitian ini merupakan penelitian retrospective cohort dengan mengambil data sekunder dari rekam medis pasien dari tahun 2017 sampai 2021. Total sampel sebanyak 100 pasien Hirschprung dibagi menajadi dua kelompok, yaitu teknik operasi transanal Swenson-like dan teknik operasi Soave. Data ditabulasi dan dianalisis statistik dengan menggunakan uji deskriptif dan asosiasi.

Hasil: Terdapat perbedaan lama waktu operasi berdasarkan teknik operasi yang digunakan, dengan median 120,00 menit pada kelompok teknik transanal Swenson-like 1 tahap dan 150,17 menit pada kelompok transanal Soave. Durasi lama rawat inap pasien teknik operasi Swenson-like lebih singkat dibandingkan teknik Soave (p < 0,001). Komplikasi enterokolitis paska bedah lebih jarang terjadi pada teknik operasi Swenson-like dibandingkan dengan Soave.

Simpulan: Terdapat perbedaan luara klinis pada pasien hirschsprung paska tindakan bedah dengan teknik transanal Swenson-like dan Soave 1 tahap.

Introduction: Psoriasis is a chronic inflammation of the skin. The remission rate of psoriasis is 10-60%, with the risk of depression, skin cancer and suicide. Inflammation leads decrease of skin hydration, and pH, thus it makes destruction of skin barrier. Therefore, this study aimed to determine the function and integrity of the skin barrier as seen from TEWL and pH in psoriatic and non-psoriatic lesions in psoriasis vulgaris patients.

Method:  This was a crossectional study, that was conducted in RSUP Prof. Dr. I.G.N.G. Ngoerah, Denpasar around May – July 2022. This study used a consecutive sampling technique, after that the sample was adjusted with the inclusion and exclusion criteria. The data was analyzed by using SPSS version 25. Bivariate analysis used Independent T-Test, for the multivariate analysis used linear regression.

Results: This study obtained 28 samples with the majority was male (60.7%). The average age of the sample was 45.68±15.04. The mean TEWL value in the psoriatic lesion group (24.78 ± 4.77) was higher and the mean pH was lower (5.25 ± 0.18) than the non-psoriatic lesion (TEWL:11.75 ± 2.79; pH 5.63 ± 0.21). TEWL and pH ratio between psoriatic lession and non psoriatic lesion is  (TEWL: 2,19 ± 0,11; pH 0,93 ± 0,01).  The difference was statistically significant (p<0,01).

Conclusion: There was a significant relationship between an increase in TEWL value and a decrease in pH value in the psoriatic group of lesions compared to the non-psoriatic group.

Latar Belakang : Psoriasis merupakan penyakit inflamasi kronis pada kulit. Psoriasis dilaporkan memiliki tingkat remisi yang tinggi sebesar 10-60%, dengan risiko depresi, kanker kulit, dan bunuh diri. Inflamasi dapat menyebabkan penurunan hidrasi dan PH kulit, sehingga menyebakan kerusakan barrier kulit. Tujuan dari penelitian ini adalah untuk mengetahui fungsi dan integritas barrier kulit dilihat dari TEWL dan pH pada lesi psoriatic dan non-lesi psoriatic pada pasien psoriasis vulgaris.

Metode: Penelitian ini merupakan penelitian potong lintang yang dilakukan di RSUP Prof. Dr. I.G.N.G. Ngoerah, Denpasar, dilakukan pada bulan Mei – Juli 2022. Teknik pengambilan sampel yang digunakan yaitu consecutive sampling dan diseleksi berdasarkan kriteria inklusi dan eksklusi yang telah di tentukan. Data di analisis menggunakan SPSS versi 25. Analisis bivariat menggunakan Independent T-Test, dan analisis multivariat yang digunakan menggunakan regresi linear.

Hasil : Penelitian ini mendapatkan 28 sampel dengan mayoritas berjenis kelamin laki-laki (60,7%). Rata-rata sampel berusia 45,68±15,04. Rerata nilai TEWL pada pada kelompok lesi psoriatic (24,78 ± 4,77) lebih tinggi dan rerata pH lebih rendah (5,25 ± 0,18) dibandingkan non-lesi psoriatic (TEWL:11,75 ± 2,79; pH 5,63 ± 0,21). Rasio TEWL dan pH lesi psoriatic dibandingkan non-lesi psoriatic adalah (TEWL: 2,19 ± 0,11; pH 0,93 ± 0,01). Perbedaan tersebut signifikan secara statistik (p<0,01).

Simpulan: Adapun kesimpulan dari penelitian ini yakni lesi psoriatic secara signifikan memiliki nilai TEWL yang lebih tinggi namun pH yang lebih rendah dengan rasio TEWL sebesar 2,19 ± 0,11 dan rasio pH sebesar  0,93 ± 0,01.